Twin pregnancy: is it a risk factor for long-term cardiovascular disease?

OBJECTIVE: To investigate whether twin pregnancy increases the risk for long-term maternal cardiovascular disease (CVD). STUDY DESIGN: A retrospective population-based cohort study compared the incidence of long-term CVD in a cohort of women with and without a previous twin delivery. SETTING: Deliveries occurred between the years 1988 and 2012. PATIENTS: Patients who had a twin birth between years 1988 and 2012 were included in the study, patient that had a singleton delivery included in the control group. MAIN OUTCOME MEASURES: CVD was divided into four categories according to severity and type. Kaplan-Meier survival curve was used to estimate cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazard ratios (HR) for CVD. RESULTS: During the study period, there were 100 387 women that met the inclusion criteria, 4.6% (n = 4647) delivered twins at least once during the period. The incidence of CVD was 1% in women who had a twin delivery and 1.12% in women who had a singleton delivery. There was no difference in the cumulative incidence of cardiovascular hospitalizations among women who had twin deliveries as compared with singletons. When performing a Cox proportional hazard model, a history of twin delivery did not increase the risk for long-term maternal cardiovascular hospitalizations (adjusted HR = 1.0, 95% CI = 0.8-1.1, p = 0.698). CONCLUSIONS: Twin pregnancy is not associated with an increased risk for long-term maternal CVD.