Optimal cutoffs of growth discordance for the risk of preeclampsia in twin pregnancies: A single-center retrospective cohort study

Jie Zhu; Ping An; Huanqiang Zhao; Ying Zhao; Jizi Zhou; Qiongjie Zhou; Xiaotian Li; Yu Xiong

doi:10.3389/fcvm.2022.1073729

Optimal cutoffs of growth discordance for the risk of preeclampsia in twin pregnancies: A single-center retrospective cohort study

Front Cardiovasc Med. 2023 Jan 16:9:1073729. doi: 10.3389/fcvm.2022.1073729. eCollection 2022.

Authors

Jie Zhu^{1

2}, Ping An^{1

2}, Huanqiang Zhao^{1

2}, Ying Zhao^{1

2}, Jizi Zhou^{1

2}, Qiongjie Zhou^{1

2}, Xiaotian Li^{1

2}, Yu Xiong^{1

2}

Affiliations

¹ Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
² The Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China.

Abstract

Objective: To explore the optimal cutoffs of growth discordance for the risk of preeclampsia in twin pregnancies.

Methods: A retrospective cohort study in a university hospital which included twins delivered from February 2013 to September 2020. Restrictive cubic spline (RCS) model was applied to the trend of intertwin birthweight difference (BWD) with the risk of preeclampsia. Logistic regression and subgroup analysis were performed to find the cut-off with statistical significance and clinical meaningfulness.

Results: A total of 2,631 women pregnant with twins were enrolled. RCS showed a nonlinear upward trend of preeclampsia with BWD, and the BWD of 15% was the initial rising point. With the confounders adjusted, only the group with BWD ≥ 25% was found to be significantly associated with an increased risk of preeclampsia (adjusted odds ratio [aOR], 2.44; 95% confidence interval [CI]: 1.74-3.42). Additionally, subgroup analysis showed that both monochorionic (MC) and small for gestational age (SGA) twins were more likely to complicate with preeclampsia.

Conclusion: The growth discordance of 15% during pregnancy may be the preventive point of preeclampsia, and 25% may be the interventional point.

Keywords: birthweight difference; gestational hypertensive disorders; growth discordance; preeclampsia; twin pregnancy.

Grants and funding

This study was supported by the National Key Research and Development Program (2021YFC2701600 and 2021YFC2701601), Clinical Research Plan of SHDC (SHDC2020CR6021), National Science Foundation of China (81741047), the National Science Fund of Shanghai, China (No. 22ZR1409000), and Medical Innovation Research Program of Shanghai, China (No. 21Y1190 8000).