Effect of adenomyosis on adverse obstetrical outcomes in twin pregnancies achieved with assisted reproductive technology

Mi Sun Kim, Ji Hyon Jang, Seulgee Park, Eun Hee Ahn, Sang Hee Jung
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · 2021 · vol. 41(8) , pp. 1225–1229 · doi:10.1080/01443615.2020.1867969 · PMID:33890530 · W3154561004
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Twin pregnancies with adenomyosis showed increased fetal loss, early preterm delivery, hypertensive disorders, transfusion rates, and smaller babies compared to controls without adenomyosis.

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Abstract

The incidence of twin pregnancy with adenomyosis (AD) is increasing due to advanced maternal age and infertility treatment. We retrospectively analysed the data of 45 dichorionic twin pregnancies complicated with AD in contrast to a control group of dichorionic twin pregnancies without AD (n = 130). Compared with those in the control group, the AD group had a higher overall foetal loss rate (8.9% vs. 0.8%; adjusted p = .031; odds ratio (OR), 13.6; 95% confidence interval (CI), 1.27–146.3), higher early preterm delivery rate (20% vs. 6.9%; adjusted p = .007; OR, 4.22; 95% CI, 1.47–12.13) and higher rate of hypertensive disorders of pregnancy (26.7% vs. 7.7%; adjusted p = .005; OR, 3.94; 95% CI, 1.5–10.2). Patients in the AD group were significantly more likely to require transfusion during or after delivery (17.8% vs. 5.4%; p = .026) and have smaller babies (2168 g vs. 2399 g; p = .004) compared with those in the control group. This is the first study to report that twin pregnancies with AD may be treated as high-risk for placental dysfunction and may need closer monitoring during pregnancy.Impact StatementWhat is already known on this subject? The incidence of twin pregnancy with adenomyosis (AD) is increasing due to advanced maternal age and infertility treatment. However, there are very few studies on the effect of AD on pregnancy outcomes.What the results of this study add? This is the first study to report that twin pregnancies with AD have higher rates of early preterm delivery, hypertensive disorders of pregnancy, and transfusion compared to controls.What the implications are of these findings for clinical practice and/or further research? The results of this study can be used in counselling twin pregnancies with AD. Further research is needed to confirm the current findings.

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Condition tags

adenomyosisinfertility

MeSH descriptors

Adenomyosis Pregnancy Complications Pregnancy Outcome Pregnancy, Twin Twins, Dizygotic Adenomyosis Adult Blood Transfusion Blood Transfusion Case-Control Studies Female Humans Infant, Newborn Pregnancy Pregnancy Complications Pregnancy Complications Pregnancy Outcome Premature Birth Premature Birth Premature Birth

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