General Obstetrics and Gynecology ObstetricsHypertensive disorders in twin versus singleton gestations☆,☆☆
Section snippets
Material and methods
The study population consisted of healthy women with either singleton or twin gestations who were enrolled in two separate multicenter randomized trials comparing low-dose aspirin with placebo for the prevention of preeclampsia.6, 7 The trials were designed and conducted by members of the Network of Maternal-Fetal Medicine Units for the National Institute of Child Health and Human Development. The subjects for one of the trials were healthy nulliparous women with singleton pregnancies who were
Results
Table I describes the baseline characteristics at the time of random assignment for women with singleton and twin gestations.
Empty Cell Twin gestations (n = 684) Singleton gestations (n = 2946) Statistical significance Maternal age (y, mean ± SD) 25.0 ± 6.0 20.4 ± 4.6 P < .0001 Systolic blood pressure (mm Hg, mean ± SD) 110 ± 11 106 ± 11 P < .0001 Diastolic blood pressure (mm Hg, mean ± SD) 63 ± 9.1 61 ± 9.0 P < .0001 Smoking during pregnancy (%) 14.5 11.0 P = .0100 Nulliparous (%) 38.9 100 P
Comment
Several studies have described the risk factors and the incidences of hypertensive disorders among women with twin pregnancies as compared with those among women with singleton pregnancies.1, 2, 3, 4, 5 Most of these studies are hospital-based, however, and thus their findings are affected by selection bias because women with these obstetric complications are more likely to be referred to tertiary medical centers.1, 2, 3 Only two studies evaluated women prospectively from <24 weeks’ gestation
Acknowledgements
`The National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units was established by the Institute in 1986. In addition to the authors the members of the Network and their institutional affiliations are as follows: J. Harger, M. Cotroneo, and T. Kamon, Magee-Women’s Hospital, Pittsburgh; B. Mercer and R. Ramsey, University of Tennessee, Memphis; Y. Rabello, D. McCart, and E. Mueller, University of Southern California, Los Angeles; R. Goldenberg and R.
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Supported by grants HD19897, HD21410, HD21414, HD21434, HD27860, HD27861, HD27869, HD27883, HD27889, HD27905, HD27915, and HD27917 from the National Institute for Child Health and Human Development.
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Reprint requests: Baha M. Sibai, MD, Department of Obstetrics and Gynecology, University of Tennessee, Memphis, 853 Jefferson Ave, Room E102, Memphis, TN 38103.