Abstract
Objective
Twin pregnancy increases the risk for short term maternal morbidities such as hypertensive disorders and gestational diabetes mellitus. We sought to investigate whether twin pregnancy increases the risk for long-term maternal cardiovascular disease (CVD).
Study Design
A population-based study compared the incidence of long-term CVD in a cohort of women with and without a previous twin delivery. Deliveries occurred between the years 1988-2012, with a mean follow-up duration of 11.2 years. CVD was divided into 4 categories according to severity and type including simple and complex CVD (eg, angina pectoris and congestive heart failure, respectively), and invasive and noninvasive cardiac procedures (eg, insertion of a stent and a treadmill stress test, respectively). Kaplan-Meier survival curve was used to estimate cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazard ratios (HR) for CVD.
Results
During the study period there were 100,387 women that met the inclusion criteria, 4.6% (n=4,647) occurred in patient who delivered twins at least once. No significant difference was noted in the cumulative incidence of cardiovascular hospitalizations among women who had twin deliveries as compare with singletons, using a Kaplan-Meier survival curve (Figure).
Patients following twin delivery did not have higher rates of long-term CVD (Table).
When performing a Cox proportional hazard model, adjusted for diabetes mellitus, hypertensive disorders and obesity, a history of twin delivery did not increase the risk for long-term maternal cardiovascular hospitalizations (adjusted HR=1.0, 95% CI 0.8-1.1, P=0.698). However, recurrent episodes of twin delivery increased the risk for noninvasive cardiac procedures (2.7% in patients having twins more than once vs. 0.8% in patients following one twin pregnancy, vs. 1.0% in patients following singletons; P=0.031).
Conclusion
Twin pregnancy does not increase the risk for long-term maternal CVD.
Twin pregnancy increases the risk for short term maternal morbidities such as hypertensive disorders and gestational diabetes mellitus. We sought to investigate whether twin pregnancy increases the risk for long-term maternal cardiovascular disease (CVD).
Study Design
A population-based study compared the incidence of long-term CVD in a cohort of women with and without a previous twin delivery. Deliveries occurred between the years 1988-2012, with a mean follow-up duration of 11.2 years. CVD was divided into 4 categories according to severity and type including simple and complex CVD (eg, angina pectoris and congestive heart failure, respectively), and invasive and noninvasive cardiac procedures (eg, insertion of a stent and a treadmill stress test, respectively). Kaplan-Meier survival curve was used to estimate cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazard ratios (HR) for CVD.
Results
During the study period there were 100,387 women that met the inclusion criteria, 4.6% (n=4,647) occurred in patient who delivered twins at least once. No significant difference was noted in the cumulative incidence of cardiovascular hospitalizations among women who had twin deliveries as compare with singletons, using a Kaplan-Meier survival curve (Figure).
Patients following twin delivery did not have higher rates of long-term CVD (Table).
When performing a Cox proportional hazard model, adjusted for diabetes mellitus, hypertensive disorders and obesity, a history of twin delivery did not increase the risk for long-term maternal cardiovascular hospitalizations (adjusted HR=1.0, 95% CI 0.8-1.1, P=0.698). However, recurrent episodes of twin delivery increased the risk for noninvasive cardiac procedures (2.7% in patients having twins more than once vs. 0.8% in patients following one twin pregnancy, vs. 1.0% in patients following singletons; P=0.031).
Conclusion
Twin pregnancy does not increase the risk for long-term maternal CVD.
| Original language | English |
|---|---|
| Pages (from-to) | S265-S266 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 210 |
| Issue number | 1 |
| DOIs | |
| State | Published - 31 Jan 2014 |