Noriyuki Iwama1,2, Hirohito Metoki3,4,5, Hidekazu Nishigori2,5, Satoshi Mizuno4, Fumiaki Takahashi6, Kosuke Tanaka2, Zen Watanabe2, Masatoshi Saito2, Kasumi Sakurai5, Mami Ishikuro4,5, Taku Obara4,5,7, Nozomi Tatsuta5, Ichiko Nishijima4,5, Takashi Sugiyama8, Ikuma Fujiwara5, Shinichi Kuriyama4,5,9, Takahiro Arima5, Kunihiko Nakai5, Nobuo Yaegashi2,4,5. 1. Department of Obstetrics and Gynecology, Osaki Citizen Hospital, Osaki. 2. Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine. 3. Division of Public Health, Hygiene and Epidemiology, Tohoku Medical Pharmaceutical University. 4. Tohoku Medical Megabank Organization, Tohoku University. 5. Environment and Genome Research Center, Tohoku University Graduate School of Medicine. 6. Clinical Research, Innovation and Education Center. 7. Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi. 8. Department of Obstetrics and Gynecology, Ehime University School of Medicine, Toon, Ehime. 9. International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan.
Abstract
OBJECTIVES: Although a twin pregnancy is a risk factor for hypertensive disorders of pregnancy, studies investigating longitudinal blood pressure changes during twin pregnancies are uncommon. The aims of this study were to evaluate the longitudinal blood pressure changes during twin pregnancies and to compare blood pressure levels between twin and singleton pregnancies. METHODS: Five hundred dichorionic diamniotic twin, 240 monochorionic diamniotic twin, and 80 775 singleton pregnancies were included in this Japanese prospective birth cohort study. A marginal model was applied to evaluate the SBP, DBP, and mean arterial pressure levels during early gestation, mid-gestation, and late gestation. RESULTS: The blood pressure levels fell from early-to-mid-gestation and rose after mid-gestation in the dichorionic and monochorionic diamniotic twin pregnancies. The SBP and mean arterial pressure levels during early gestation and the DBP and mean arterial pressure levels during late gestation were higher in the dichorionic diamniotic twin pregnancies than those in the singleton pregnancies. The blood pressure levels in the monochorionic diamniotic twin pregnancies were higher than those in the singleton pregnancies at each gestational stage, except for the SBP during late gestation. CONCLUSION: Although the longitudinal blood pressure changes during twin pregnancies were similar to those during singleton pregnancies, the blood pressure levels during twin pregnancies were higher. Further studies that examine the associations between the longitudinal blood pressure changes during pregnancy and the perinatal outcomes in twin pregnancies are necessary.
OBJECTIVES: Although a twin pregnancy is a risk factor for hypertensive disorders of pregnancy, studies investigating longitudinal blood pressure changes during twin pregnancies are uncommon. The aims of this study were to evaluate the longitudinal blood pressure changes during twin pregnancies and to compare blood pressure levels between twin and singleton pregnancies. METHODS: Five hundred dichorionic diamniotic twin, 240 monochorionic diamniotic twin, and 80 775 singleton pregnancies were included in this Japanese prospective birth cohort study. A marginal model was applied to evaluate the SBP, DBP, and mean arterial pressure levels during early gestation, mid-gestation, and late gestation. RESULTS: The blood pressure levels fell from early-to-mid-gestation and rose after mid-gestation in the dichorionic and monochorionic diamniotic twin pregnancies. The SBP and mean arterial pressure levels during early gestation and the DBP and mean arterial pressure levels during late gestation were higher in the dichorionic diamniotic twin pregnancies than those in the singleton pregnancies. The blood pressure levels in the monochorionic diamniotic twin pregnancies were higher than those in the singleton pregnancies at each gestational stage, except for the SBP during late gestation. CONCLUSION: Although the longitudinal blood pressure changes during twin pregnancies were similar to those during singleton pregnancies, the blood pressure levels during twin pregnancies were higher. Further studies that examine the associations between the longitudinal blood pressure changes during pregnancy and the perinatal outcomes in twin pregnancies are necessary.