Twin pregnancies can aggravate maternal renal function in late pregnancy
compared to singleton pregnancies: a retrospective study
Abstract
Objective: This study aimed to evaluate the differences in maternal
renal function between singleton and twin pregnancies in the second half
of pregnancy. Design: Retrospective study Setting: Japanese Red Cross
Aichi Medical Center Nagoya Daiichi Hospital from January 2019 to June
2021. Population: This study included 1711 pregnant women with 1547
singleton pregnancies and 164 twin pregnancies. Methods: Patients
underwent renal function tests (serum blood urea nitrogen, creatinine,
and estimated glomerular filtration rate [eGFR]) at least one month
prior to delivery. Main Outcome Measure: Maternal renal dysfunction,
defined as serum creatinine of above 0.8 mg/dL. Results: Serum
creatinine level was significantly higher and eGFR was significantly
lower in twin pregnancies than that in singleton pregnancies (p
< 0.001). In addition, the rate of renal dysfunction was
significantly higher in twin than that in singleton pregnancies (7.9%
vs. 2.6%; p < 0.001). Multivariate analysis revealed that
twin pregnancy (odds ratio [OR] 3.38), nulliparity (OR 2.31), and
preeclampsia (OR 3.64) were significant risk factors for maternal renal
dysfunction. Maternal renal dysfunction was observed in 13 twin
pregnancies, all of which recovered to within normal limits during the
postpartum period. Conclusions: Twin pregnancy is a significant risk
factor for maternal renal dysfunction. Careful attention should be paid
to maternal renal dysfunction in the management of twin pregnancies.
Funding: Japanese Red Cross, Nagoya Daiichi Hospital Research Grant
(grant number NFRCH22-0011). Keywords: chorionicity, renal function,
serum creatinine concentration, singleton pregnancy, twin pregnancy