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dc.contributor.authorBolger, Aidan
dc.contributor.authorSiddiqui, Farah
dc.date.accessioned2023-03-17T13:58:17Z
dc.date.available2023-03-17T13:58:17Z
dc.date.issued2021-11-20
dc.identifier.citationCauldwell, M., Steer, P. J., Adamson, D., Alexander, C., Allen, L., Bhagra, C., Bolger, A., Bonner, S., Calanchini, M., Carroll, A., Casey, R., Curtis, S., Head, C., English, K., Hudsmith, L., James, R., Joy, E., Keating, N., MacKiliop, L., McAuliffe, F., … Turner, H. E. (2022). Pregnancies in women with Turner syndrome: a retrospective multicentre UK study. BJOG : an international journal of obstetrics and gynaecology, 129(5), 796–803. https://doi.org/10.1111/1471-0528.17025en_US
dc.identifier.other10.1111/1471-0528.17025
dc.identifier.urihttp://hdl.handle.net/20.500.12904/16506
dc.description.abstractObjective: 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 outcome measures: 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.
dc.description.urihttps://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.17025en_US
dc.language.isoenen_US
dc.subjectAortic dissectionen_US
dc.subjectTurner syndromeen_US
dc.subjectPregnancyen_US
dc.titlePregnancies in women with Turner syndrome: a retrospective multicentre UK studyen_US
dc.typeArticleen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US
rioxxterms.versionNAen_US
rioxxterms.versionofrecordhttps://doi.org/10.1111/1471-0528.17025en_US
rioxxterms.typeJournal Article/Reviewen_US
refterms.panelUnspecifieden_US
html.description.abstractObjective: 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 outcome measures: 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.en_US


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