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The Hispanic paradox in twin pregnancies
Barbara Luke1, Morton B Brown, Ruta B Misiunas
1University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA. b.luke@miami.edu
Summary
Hispanic and Black twin pregnancies show distinct fetal growth and gestation patterns. Hispanic twins experienced longer gestations and faster growth, while Black twins had slower fetal growth rates.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Epidemiology
- Maternal-Fetal Medicine
Background:
- Racial and ethnic disparities in pregnancy outcomes are well-documented in singleton gestations.
- Understanding these disparities in twin pregnancies is crucial for targeted interventions.
- Pregravid body mass index (BMI) is a known factor influencing fetal development.
Purpose of the Study:
- To compare gestation length, fetal growth, and birthweight among different racial/ethnic groups in twin pregnancies.
- To investigate the influence of pregravid BMI on these outcomes in twin gestations.
- To identify potential ethnic paradoxes in twin pregnancy development.
Main Methods:
- Analysis of 3,036 twin pregnancies with gestation of 28 weeks or more.
- Stratification by race/ethnicity (White, Black, Hispanic) and pregravid BMI (<25.0 vs. >=25.0).
- Multiple regression modeling to control for confounders, with White non-Hispanic women as the reference.
Main Results:
- Hispanic women had the longest gestations, highest average birthweights, and lowest rates of adverse outcomes (low birthweight, preterm birth).
- Multivariate analysis revealed significantly longer gestations (7.8 days) and faster fetal growth rates in Hispanic women.
- Black women exhibited significantly slower rates of fetal growth compared to the reference group.
Conclusions:
- Findings in twin pregnancies mirror singleton disparities, highlighting the 'Hispanic paradox' of longer gestations and accelerated fetal growth.
- Race/ethnicity significantly impacts gestation length and fetal growth rates in twin pregnancies.
- These results underscore the need for race/ethnicity-specific considerations in managing twin pregnancies.