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Q&A

Hypertension

Poster Session 2

(529) Association between method of conception of DCDA twin pregnancies and hypertensive disorders of pregnancy

Tuesday, February 13, 2024

3:30 PM – 5:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Alexandra N. Mills, BS (she/her/hers)

Medical Student
Icahn School of Medicine at Mount Sinai
New York, NY, United States

Coauthor(s)

Manasa G. Rao, MD

OBGYN Resident
Columbia University, Icahn School of Medicine at Mount Sinai
New York, NY, United States
SK

Sonia Khurana, BA

Icahn School of Medicine at Mount Sinai Hospital
New York, NY, United States
IB

Isabelle C. Band, BA

Icahn School of Medicine at Mount Sinai
New York, NY, United States
EK

Elianna Kaplowitz, MPH

Mount Sinai Hospital
New York, NY, United States
Chelsea A. DeBolt, MD

MFM Fellow
Mount Sinai Hospital
New York, NY, United States

Objective: Twin pregnancy is a known risk factor for hypertensive disease of pregnancy (HDP). Conception via In vitro fertilization (IVF) has been associated with HDP. However, current data on risk of HDP development in twin pregnancies conceived via IVF is limited and conflicting. We aim to investigate whether conception of dichorionic diamniotic (DCDA) twins via IVF is associated with increased odds of HDP compared to DCDA pregnancies conceived spontaneously, via intrauterine insemination (IUI) or ovulation induction (OI).

Study Design: Retrospective cohort of DCDA twins delivered at Mount Sinai Hospital from 2008-2022. Primary outcome was HDP (gestational hypertension and preeclampsia [PEC]) defined by ACOG criteria. Secondary outcomes included mode of delivery, birthweight, gestational age at delivery, and NICU admission. Outcomes were compared between DCDA pregnancies conceived via IVF and those conceived spontaneously/IUI/OI. Univariable and multivariable regression analyses were performed.

Results: Of 657 DCDA pregnancies included in this study, 265 (40.3%) were conceived via IVF and 392 (59.7%) were conceived spontaneously/IUI/OI. There was no significant difference in HDP among DCDA pregnancies conceived via IVF compared to spontaneous/IUI/OI conception (p=0.56). Patients who conceived via IVF were more likely to be nulliparous, older, have lower BMI, and commercial insurance, compared to patients who conceived spontaneously/IUI/OI (all p< 0.0001). Adjusting for known risk factors of HDP, IVF DCDA pregnancies were at 2.03 increased odds of PEC without severe features compared to spontaneous/IUI/OI DCDA pregnancies (Table 1). Secondary outcomes showed IVF DCDA pregnancies were more likely to be delivered by Cesarean delivery (p=0.0001) and were more likely to have lower birth weight (p=0.03) compared to spontaneous/IUI/OI pregnancies.

Conclusion: Conception of DCDA twins via IVF does not appear to be associated with an increase in HDP compared to DCDA twins conceived spontaneously/IUI/OI. While IVF DCDA twins may be at increased odds of developing PEC without severe features, larger studies are needed.