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Gestational hypertensive disease and small for gestational age infants in twin pregnancy: A systematic review and

Mingbo Wang1, Xin Wang1, Zhifang Chen2

  • 1Medical School of Nantong University, Nantong, China.

The Journal of Obstetrics and Gynaecology Research
|August 17, 2022
PubMed

Insights

Gestational hypertension diseases (GHD) increase the risk of small for gestational age (SGA) in dichorionic twin pregnancies. The diagnostic reference for SGA significantly impacts the observed association between GHD and SGA outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Maternal-Fetal Medicine

Background:

  • Gestational hypertension diseases (GHD) and small for gestational age (SGA) are significant complications in twin pregnancies.
  • Understanding the relationship between GHD and SGA is crucial for optimizing perinatal outcomes in multiple gestations.

Approach:

  • A systematic review and meta-analysis were conducted following PRISMA guidelines.
  • Studies were systematically searched across major databases (PubMed, Web of Science, Cochrane Library, Embase) until January 2022.
  • Subgroup analyses were performed based on chorionicity and SGA diagnostic criteria, utilizing random-effect or fixed-effect models as appropriate.

Key Points:

  • The overall analysis indicated an increased risk of SGA in twin pregnancies complicated by GHD (OR = 1.57).
  • The association between GHD and SGA was significant when using twin birth weight references for SGA diagnosis (OR = 2.14) but not when using singleton birth weight references (OR = 1.17).
  • SGA was significantly associated with GHD in dichorionic (DC) twin pregnancies (OR = 1.68) but not in monochorionic (MC) twin pregnancies (OR = 1.68).

Conclusions:

  • Gestational hypertension diseases in dichorionic twin pregnancies are linked to a higher risk of developing small for gestational age infants.
  • The choice of diagnostic reference for SGA significantly influences the observed association with GHD in twin pregnancies.
  • Further research is warranted to confirm these findings and elucidate the underlying mechanisms.
Abstract

Keywords:
hypertensionmeta-analysissmall for gestational agesystematic reviewtwin pregnancy

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