(1162) Increased Adverse Perinatal Outcomes (APO) for Twin Pregnancies Complicated by Congenital Heart Disease (CHD).

Friday, January 31, 2025

4:00 PM – 6:00 PM

Submitting Author(s)

Rainney Chiu, BS, MPH (she/her/hers)

Medical Student
University Of California, Davis
University of California, Davis, California, United States

Presenting Author(s)

Lihong Mo, MD, PhD

Maternal Fetal Medicine Physician
UC Davis Health
Sacramento, California, United States

Coauthor(s)

HH

Herman L. Hedriana, MD

Maternal Fetal Medicine Physician
UC Davis Health
Sacramento, California, United States
SH

Shinjiro Hirose, MD

UC Davis Health
UC Davis, California, United States
SS

Sherzana Sunderji, MD

UC Davis Health
UC Davis Health, California, United States
AM

Amelia Mclennan, MD

UC Davis Health
UC Davis Health, California, United States

Objective: APO, namely preterm birth (PTB), hypertensive disorders of pregnancy (HDP), and placental abruption have been associated with CHD in singleton pregnancies. This association has not been investigated in twin pregnancies. The aim of this study is to 1) evaluate the prevalence of APO in twin pregnancies affected by CHD using a large national database; 2) identify pregnancy characteristics associated with the APOs using a local database.

Study Design: A retrospective case-control study of twin pregnancies with CHD was conducted on Center of Disease Control and Prevention Natality Database from 1995-2000 (403,018 births) and 2016-2022 (842,878 births). Maternal demographics and perinatal outcomes were compared. Subsequently a local twin case series with CHD was reviewed for characteristics leading to APO.

Results: Demographically, there was no significant difference in twin pregnancies with or without CHD in both periods The CHD group showed significantly increased PTB: 1995-2000: < 37 weeks: Odds Ratio [OR], 2.37; (2.04-2.77 95% Confidence Interval [95%CI]); < 28 weeks: OR, 3.07; (2.54-3.71 95%CI); 2016-2022: < 37 weeks: OR, 1.91; (1.64-2.24 95%CI); < 28 weeks: OR, 2.18; (1.70-2.80 95%CI). Eclampsia was higher with CHD :1995-2000: OR, 3.35; (2.30-4.89 95%CI); 2016-2022: OR, 5.32; (3.60-7.90 95%CI). Other HDP were not significantly increased in either cohort. Local center case series revealed that PTB was due to 6.7% spontaneous and 93.3% iatrogenic (18.2% for maternal indications, 81.8% for fetal indications).

Conclusion:

CHD is associated with increased odds of PTB and eclampsia in twin pregnancies in CDC database collected in 1995-2000 and 2016-2022. Our single center study shed light on the common reasons for PTB in this CHD population. Further characterization with a larger sample size is needed to elucidate the incidence of APOs in twin pregnancies complicated by CHD.