TY - JOUR
T1 - Pregnancies in women with Turner Syndrome
T2 - a retrospective multicentre UK study
AU - Cauldwell, Matthew
AU - Steer, Philip J
AU - Adamson, Dawn
AU - Alexander, Claire
AU - Allen, Lowri
AU - Bhagra, Catriona
AU - Bolger, Aidan
AU - Bonner, Samantha
AU - Calanchini, Matilde
AU - Carroll, Aisling
AU - Casey, Ruth
AU - Curtis, Stephanie
AU - Head, Catherine
AU - English, Kate
AU - Hudsmith, Lucy
AU - James, Rachael
AU - Joy, Eleanor
AU - Keating, Niamh
AU - MacKiliop, Lucy
AU - McAuliffe, Fionnuala
AU - Morris, R Katie
AU - Mohan, Aarthi
AU - Von Klemperer, Katherine
AU - Kaler, Mandeep
AU - Rees, D Aled
AU - Shetty, Asha
AU - Siddiqui, Farah
AU - Simpson, Lydia
AU - Stocker, Linden
AU - Timmons, Paul
AU - Vause, Sarah
AU - Turner, Helen E
N1 - This article is protected by copyright. All rights reserved.
PY - 2021/11/20
Y1 - 2021/11/20
N2 - OBJECTIVE: To determine the characteristics and outcomes of pregnancy in women with Turner Syndrome.DESIGN: Retrospective 20-year cohort study (2000-2020).SETTING: 16 tertiary referral maternity units in the UK.POPULATION OR SAMPLE: 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%) of pregnancies in women with karyotype 45,X were spontaneous, compared with 53/66 (80.3%) with mosaic karyotype 45,X/46,XX (p<0.0001). Women with mosaic 45,X/46,XX were younger at first pregnancy by 5.5-8.5 years compared to other TS-karyotype groups (p<0.001), and more likely to have a spontaneous menarche (75.8% vs 50% or less, p=0.008). There were 17 miscarriages, 3 terminations of pregnancy, 2 stillbirths and 105 livebirths. 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 six months of delivery. 10/106 (9.4%) births with gestational age data were preterm and 22/96 (22.9%) with singleton birthweight/gestational age data weighed <10th centile. The caesarean section rate was 72/107 (67.3%). In only 73/127 (57.4%) of pregnancies was there documentation of cardiovascular imaging within 24 months prior to conceiving.CONCLUSIONS: Pregnancy in women with TS is associated with major maternal cardiovascular risks and deserve thorough cardiovascular assessment and counselling prior to assisted or spontaneous pregnancy managed by a specialist team.
AB - OBJECTIVE: To determine the characteristics and outcomes of pregnancy in women with Turner Syndrome.DESIGN: Retrospective 20-year cohort study (2000-2020).SETTING: 16 tertiary referral maternity units in the UK.POPULATION OR SAMPLE: 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%) of pregnancies in women with karyotype 45,X were spontaneous, compared with 53/66 (80.3%) with mosaic karyotype 45,X/46,XX (p<0.0001). Women with mosaic 45,X/46,XX were younger at first pregnancy by 5.5-8.5 years compared to other TS-karyotype groups (p<0.001), and more likely to have a spontaneous menarche (75.8% vs 50% or less, p=0.008). There were 17 miscarriages, 3 terminations of pregnancy, 2 stillbirths and 105 livebirths. 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 six months of delivery. 10/106 (9.4%) births with gestational age data were preterm and 22/96 (22.9%) with singleton birthweight/gestational age data weighed <10th centile. The caesarean section rate was 72/107 (67.3%). In only 73/127 (57.4%) of pregnancies was there documentation of cardiovascular imaging within 24 months prior to conceiving.CONCLUSIONS: Pregnancy in women with TS is associated with major maternal cardiovascular risks and deserve thorough cardiovascular assessment and counselling prior to assisted or spontaneous pregnancy managed by a specialist team.
KW - aortic dissection
KW - pregnancy
KW - Turner syndrome
U2 - 10.1111/1471-0528.17025
DO - 10.1111/1471-0528.17025
M3 - Article
C2 - 34800331
SN - 1470-0328
JO - BJOG: An International Journal of Obstetrics & Gynaecology
JF - BJOG: An International Journal of Obstetrics & Gynaecology
ER -