Pregnancies in women with Turner syndrome: a retrospective multicentre UK study.
BJOG
; 129(5): 796-803, 2022 Apr.
Article
em En
| MEDLINE
| ID: mdl-34800331
ABSTRACT
OBJECTIVE:
To determine the characteristics and outcomes of pregnancy in women with Turner syndrome.DESIGN:
Retrospective 20-year cohort study (2000-20).SETTING:
Sixteen tertiary referral maternity units in the UK. POPULATION OR SAMPLE A total of 81 women with Turner syndrome who became pregnant.METHODS:
Retrospective chart analysis. MAIN OUTCOMEMEASURES:
Mode of conception, pregnancy outcomes.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.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. TWEETABLE ABSTRACT Pregnancy in women with Turner syndrome is associated with an increased risk of aortic dissection.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Síndrome de Turner
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
BJOG
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Reino Unido