Fetal Sexual Dimorphism and Preeclampsia Among Twin Pregnancies.
Fetal Sexual Dimorphism and Preeclampsia Among Twin Pregnancies.
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双胎妊娠中的胎儿性别二态性和先兆子痫。
DOI：
10.1161/hypertensionaha.123.22380
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Taylor,BrandieD
中科院分区：
文献类型：
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作者：
Brown,RebekahE;Noah,AkaninyeneI;Hill,AshleyV;Taylor,BrandieD
背景技术在单胎妊娠中，在妊娠期高血压疾病中观察到胎儿性别二态性，特别是先兆子痫，这是一种病态综合征，会增加母亲及其后代成年后发病的心血管疾病的风险。然而，很少有研究探讨胎儿性别对双胎妊娠中妊娠期高血压疾病的影响。 方法我们利用来自德克萨斯州休斯顿 3 家医院的围产期数据库的数据，对 2011 年至 2022 年期间的 1032 例双胎妊娠进行了回顾性队列研究。我们根据胎儿性别配对将怀孕分为女性/女性、男性/男性和女性/男性。女性/女性对的怀孕被用作我们的参考组。我们的主要结局包括妊娠期高血压、先兆子痫、叠加先兆子痫和按分娩胎龄分类的先兆子痫。使用具有稳健误差方差的改良泊松回归模型来计算胎儿性别对与妊娠高血压疾病之间关联的相对风险和 95% CI。 结果 相对于女性/女性对的模型，女性/男性对的调整模型与早产先兆子痫相关（相对风险为 2.01 [95% CI, 1.15–3.53]）。与女性/女性胎儿性别对相比，在男性/男性对妊娠中没有观察到与其他妊娠期高血压疾病的关联。结论我们发现了女性/男性双胞胎中早产先兆子痫性别二态性的一些证据。需要进行更多的研究来了解什么生物学机制可以解释这些发现。
BACKGROUNDIn singleton pregnancies, fetal sexual dimorphism has been observed in hypertensive disorders of pregnancy, particularly preeclampsia, a morbid syndrome that increases the risk of adult-onset cardiovascular disease for mothers and their offspring. However, few studies have explored the effect of fetal sex on hypertensive disorders of pregnancy among twin pregnancies.METHODSWe conducted a retrospective cohort study of 1032 twin pregnancies between 2011 and 2022 using data from a perinatal database that recruits participants from 3 hospitals in Houston, TX. We categorized pregnancies based on fetal sex pairings into female/female, male/male, and female/male. Pregnancies with female/female pairs were used as our reference group. Our primary outcomes included gestational hypertension, preeclampsia, superimposed preeclampsia, and preeclampsia subtyped by gestational age of delivery. A modified Poisson regression model with robust error variance was used to calculate the relative risk and 95% CI for the association between fetal sex pairs and hypertensive disorders of pregnancy.RESULTSAdjusted models of female/male pairs were associated with preterm preeclampsia (relative risk, 2.01 [95% CI, 1.15–3.53]) relative to those with female/female pairs. No associations with other hypertensive disorders of pregnancy were observed among pregnancies with male/male pairs compared with those with female/female fetal sex pairs.CONCLUSIONSWe found some evidence of sexual dimorphism for preterm preeclampsia among female/male twin pairs. Additional research is needed to understand what biological mechanisms could explain these findings.