Hypertension in dichorionic twin gestations: how is birthweight affected?

Area of Science:

• Perinatal Medicine
• Maternal-Fetal Medicine
• Obstetrics

Background:

• Hypertension in pregnancy is a significant complication.
• Dichorionic twins are at increased risk for adverse birth outcomes.
• Understanding the impact of maternal hypertension on twin growth discordance is crucial.

Purpose of the Study:

• To investigate the association between maternal hypertension and birthweight discordance in dichorionic twins.
• To compare risks between gestational hypertension/preeclampsia and chronic hypertension.

Main Methods:

• Retrospective cohort study of 474 dichorionic twin pregnancies (2002-2015).
• Compared pregnancies with maternal hypertension (gestational or chronic) to uncomplicated pregnancies.
• Defined discordance as ≥20% weight difference; small for gestational age (SGA) as <10th percentile.

Main Results:

• Maternal hypertension significantly increased odds of any discordant growth (aOR 2.68) and discordance with SGA (aOR 2.94).
• Chronic hypertension showed higher odds for any discordance (aOR 4.65) and discordance with SGA (aOR 4.37).
• No significant difference observed for SGA alone.

Conclusions:

• Both gestational and chronic hypertension are associated with increased risk of discordant growth in dichorionic twins.
• Chronic hypertension presents a greater risk for discordant growth, particularly when associated with SGA.
• These findings highlight the importance of monitoring hypertensive disorders in dichorionic twin pregnancies.