ArticlePaediatric and perinatal epidemiology2023
Long-term cardiovascular mortality in women with twin pregnancies by lifetime reproductive history.
Article in Paediatric and perinatal epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 9 citations in OpenAlex.
- Longitudinal maternal hemodynamics from late pregnancy to postpartum in uncomplicated twin pregnancies-A glimpse into long-term cardiovascular risk?Acta obstetricia et gynecologica Scandinavica · 2026Article
- Hypertensive Disorders of Pregnancy, Preterm Delivery, and Infant Size: Which Mothers Have Highest Cardiovascular Disease Mortality?Paediatric and perinatal epidemiology · 2025Article
- Hospitalization for cardiovascular disease in the year after delivery of twin pregnancies.European heart journal · 2025Article
- History of multifetal gestation and long-term maternal mortality.Paediatric and perinatal epidemiology · 2024Article
- Long-term cardiovascular mortality in women with twin pregnancies by lifetime reproductive history.Paediatric and perinatal epidemiology · 2023Article
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWomen with one lifetime singleton pregnancy have increased risk of cardiovascular disease (CVD) mortality compared with women who continue reproduction particularly if the pregnancy had complications. Women with twins have higher risk of pregnancy complications, but CVD mortality risk in women with twin pregnancies has not been fully described.
objectivesWe estimated risk of long-term CVD mortality in women with naturally conceived twins compared to women with singleton pregnancies, accounting for lifetime number of pregnancies and pregnancy complications.
methodsUsing linked data from the Medical Birth Registry of Norway and the Norwegian Cause of Death Registry, we identified 974,892 women with first pregnancy registered between 1967 and 2013, followed to 2020. Adjusted hazard ratios (aHR) with 95% confidence intervals (CI) for maternal CVD mortality were estimated by Cox regression for various reproductive history (exposure categories): (1) Only one twin pregnancy, (2) Only one singleton pregnancy, (3) Only two singleton pregnancies, (4) A first twin pregnancy and continued reproduction, (5) A first singleton pregnancy and twins in later reproduction and (6) Three singleton pregnancies (the referent group). Exposure categories were also stratified by pregnancy complications (pre-eclampsia, preterm delivery or perinatal loss).
resultsWomen with one lifetime pregnancy, twin or singleton, had increased risk of CVD mortality (adjusted hazard [HR] 1.72, 95% confidence interval [CI] 1.21, 2.43 and aHR 1.92, 95% CI 1.78, 2.07, respectively), compared with the referent of three singleton pregnancies. The hazard ratios for CVD mortality among women with one lifetime pregnancy with any complication were 2.36 (95% CI 1.49, 3.71) and 3.56 (95% CI 3.12, 4.06) for twins and singletons, respectively.
conclusionsWomen with only one pregnancy, twin or singleton, had increased long-term CVD mortality, however highest in women with singletons. In addition, twin mothers who continued reproduction had similar CVD mortality compared to women with three singleton pregnancies.
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