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Pregnancies in women with Turner syndrome: a retrospective multicentre UK study.
- Source :
-
BJOG : an international journal of obstetrics and gynaecology [BJOG] 2022 Apr; Vol. 129 (5), pp. 796-803. Date of Electronic Publication: 2022 Jan 04. - Publication Year :
- 2022
-
Abstract
- Objective: To determine the characteristics and outcomes of pregnancy in women with Turner syndrome.<br />Design: Retrospective 20-year cohort study (2000-20).<br />Setting: Sixteen tertiary referral maternity units in the UK.<br />Population or Sample: A total of 81 women with Turner syndrome who became pregnant.<br />Methods: Retrospective chart analysis.<br />Main Outcome Measures: Mode of conception, pregnancy outcomes.<br />Results: We obtained data on 127 pregnancies in 81 women with a Turner phenotype. All non-spontaneous pregnancies (54/127; 42.5%) were by egg donation. Only 9/31 (29%) pregnancies in women with karyotype 45,X were spontaneous, compared with 53/66 (80.3%) pregnancies in women with mosaic karyotype 45,X/46,XX (P < 0.0001). Women with mosaic karyotype 45,X/46,XX were younger at first pregnancy by 5.5-8.5 years compared with other Turner syndrome karyotype groups (P < 0.001), and more likely to have a spontaneous menarche (75.8% versus 50% or less, P = 0.008). There were 17 miscarriages, three terminations of pregnancy, two stillbirths and 105 live births. Two women had aortic dissection (2.5%); both were 45,X karyotype with bicuspid aortic valves and ovum donation pregnancies, one died. Another woman had an aortic root replacement within 6 months of delivery. Ten of 106 (9.4%) births with gestational age data were preterm and 22/96 (22.9%) singleton infants with birthweight/gestational age data weighed less than the tenth centile. The caesarean section rate was 72/107 (67.3%). In only 73/127 (57.4%) pregnancies was there documentation of cardiovascular imaging within the 24 months before conceiving.<br />Conclusions: Pregnancy in women with Turner syndrome is associated with major maternal cardiovascular risks; these women deserve thorough cardiovascular assessment and counselling before assisted or spontaneous pregnancy managed by a specialist team.<br />Tweetable Abstract: Pregnancy in women with Turner syndrome is associated with an increased risk of aortic dissection.<br /> (© 2021 John Wiley & Sons Ltd.)
Details
- Language :
- English
- ISSN :
- 1471-0528
- Volume :
- 129
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- BJOG : an international journal of obstetrics and gynaecology
- Publication Type :
- Academic Journal
- Accession number :
- 34800331
- Full Text :
- https://doi.org/10.1111/1471-0528.17025