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Influence of maternal obesity and metabolic and vascular mediators in twin-twin transfusion syndrome.

Publication ,  Journal Article
Starnes, SE; Nardi, F; Fitchev, P; Plunkett, BA; Thorpe, C; Wang, C-H; Vogler, C; Crawford, SE
Published in: Reprod Biol
June 2019

Obesity is a risk factor for complications in singleton and twin pregnancies; however, there are limited data regarding maternal body mass index (BMI) in the setting of twin-twin transfusion syndrome (TTTS). We hypothesized that increased BMI in TTTS is associated with adverse perinatal outcomes and vascular pathology. A retrospective study of twin reversed arterial perfusion (n = 4), selective intrauterine growth restriction (n = 10) and TTTS (n = 33) was conducted. Treatment included fetoscopic laser photocoagulation (FLP) (n = 35) or Solomon technique (n = 12). Ex vivo placental intravascular injections, immunohistochemistry, and perinatal outcomes were compared by maternal BMI. In pregnancy complicated by TTTS, 16/33 women were obese (BMI > 30 kg/m2) and 11/33 were overweight (BMI 25-29.9 kg/m2). Women who were overweight or obese had an increased rate of premature rupture of membranes (PPROM), cesarean delivery, and/or concomitant co-morbidities when compared to the normal weight group. Duration of neonatal intensive care unit (NICU) admission was longer in neonates of overweight/obese women versus normal weight. Placental examination of FLP sites in the obese group showed larger infarcts, increased adipose triglyceride lipase, and a proangiogenic phenotype. Increased BMI is common in our TTTS cohort and it is associated with higher rate of co-morbidity, PPROM, prolonged NICU stay, and an imbalance of placental metabolic and vascular mediators.

Duke Scholars

Published In

Reprod Biol

DOI

EISSN

2300-732X

Publication Date

June 2019

Volume

19

Issue

2

Start / End Page

165 / 172

Location

Poland

Related Subject Headings

  • Retrospective Studies
  • Pregnancy, Twin
  • Pregnancy
  • Placenta
  • Obstetrics & Reproductive Medicine
  • Obesity
  • Humans
  • Fetofetal Transfusion
  • Female
  • Cohort Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Starnes, S. E., Nardi, F., Fitchev, P., Plunkett, B. A., Thorpe, C., Wang, C.-H., … Crawford, S. E. (2019). Influence of maternal obesity and metabolic and vascular mediators in twin-twin transfusion syndrome. Reprod Biol, 19(2), 165–172. https://doi.org/10.1016/j.repbio.2019.05.002
Starnes, Sarah E., Francesca Nardi, Philip Fitchev, Beth A. Plunkett, Constance Thorpe, Chi-Hsung Wang, Carole Vogler, and Susan E. Crawford. “Influence of maternal obesity and metabolic and vascular mediators in twin-twin transfusion syndrome.Reprod Biol 19, no. 2 (June 2019): 165–72. https://doi.org/10.1016/j.repbio.2019.05.002.
Starnes SE, Nardi F, Fitchev P, Plunkett BA, Thorpe C, Wang C-H, et al. Influence of maternal obesity and metabolic and vascular mediators in twin-twin transfusion syndrome. Reprod Biol. 2019 Jun;19(2):165–72.
Starnes, Sarah E., et al. “Influence of maternal obesity and metabolic and vascular mediators in twin-twin transfusion syndrome.Reprod Biol, vol. 19, no. 2, June 2019, pp. 165–72. Pubmed, doi:10.1016/j.repbio.2019.05.002.
Starnes SE, Nardi F, Fitchev P, Plunkett BA, Thorpe C, Wang C-H, Vogler C, Crawford SE. Influence of maternal obesity and metabolic and vascular mediators in twin-twin transfusion syndrome. Reprod Biol. 2019 Jun;19(2):165–172.
Journal cover image

Published In

Reprod Biol

DOI

EISSN

2300-732X

Publication Date

June 2019

Volume

19

Issue

2

Start / End Page

165 / 172

Location

Poland

Related Subject Headings

  • Retrospective Studies
  • Pregnancy, Twin
  • Pregnancy
  • Placenta
  • Obstetrics & Reproductive Medicine
  • Obesity
  • Humans
  • Fetofetal Transfusion
  • Female
  • Cohort Studies