New-Onset Hypertension in Late Pregnancy is Associated with Lower Fetal and Infant Mortality in Preterm Twins |
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| Authors: | Xi-Kuan Chen Graeme Smith Qiuying Yang Mark Walker |
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| Affiliation: | 1. OMNI Research Group, Department of Obstetrics &2. Gynecology, University of Ottawa, Ottawa, Ontario, Canada;3. Clinical Epidemiology Program, Ottawa Health Research Institute, University of Ottawa, Ottawa, Ontario, Canada;4. Queen's Perinatal Research Unit, Kingston General Hospital, Department of Obstetrics and Gynecology, Queens University, Kingston, Ontario, Canada |
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| Abstract: | Objective: To assess the association between new-onset hypertension in late pregnancy (NOH) and fetal and infant mortality in early preterm, late preterm, and full-term twins. Methods: We conducted a retrospective cohort study in 275, 316 twins in 1995–1997 based on multiple birth registration dataset of USA. Generalized estimating equations (GEEs) was used to evaluate the odds ratios (OR) of fetal and infant death (at individual level) associated with NOH, with adjustment of potential confounders at both twin set level and individual level. Results: The risks for early neonatal death (OR = 0.52, 95% CI: 0.36, 0.76) and late neonatal death (OR = 0.57, 95% CI: 0.37, 0.87) were decreased in early preterm twins born to mothers with NOH compared with early preterm twins born to mothers with normal blood pressure. The decreased risks for fetal death (OR = 0.40, 95% CI: 0.30, 0.53; OR = 0.46, 95% CI: 0.53, 0.65) and infant death (OR = 0.35, 95% CI: 0.28, 0.44; OR = 0.68, 95% CI: 0.51, 0.91) were associated with NOH in both early and late preterm twins, whereas no association between NOH and fetal/infant mortality were observed in full-term twins. Conclusion: NOH is associated with lower risk of fetal death and infant death in preterm twins. |
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| Keywords: | New onset hypertension in late pregnancy Fetal mortality Infant mortality Twins Preterm birth |
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