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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
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Poster Session 1

Category: Clinical Obstetrics

Poster Session 1

(312) Hypertensive Disorders in twins; Impact on Subsequent Singleton Pregnancy

Wednesday, February 11, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Nimrod Dori-Dayan, MD (he/him/his)

    Sheba Medical Center
    Tel Aviv, Tel Aviv, Israel

    • Coauthor(s)

  • MF

    Michal Fishel Bartal, MD

    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • Michal Axelrod, MD, MPH (she/her/hers)

    Sheba Medical Center
    Sheba Medical Center, HaMerkaz, Israel

  • Avihu Krieger, N/A (he/him/his)

    The Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
    Ramat Gan, Tel Aviv, Israel

  • SM

    Shali Mazaki-Tovi, MD

    Vice Chairman
    Department of Obstetrics and Gynecology, Sheba Medical Center
    Ramat Gan, Tel Aviv, Israel

  • Baha M. Sibai, MD

    Professor
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

  • KO

    Keren Ofir, MD

    Sheba Medical Center
    Sheba Medical Center, HaMerkaz, Israel

Objective:
Data on recurrent hypertensive disorders of pregnancy (HDP) after a twin gestation, particularly when stratified by the presence of severe features (SF), are limited. This study aimed to determine whether history and a severity of HDP in a twin gestation are associated with an increased risk of recurrence and fetal and maternal adverse outcomes in a subsequent singleton pregnancy, and to determine the role of severe features (SF) as a predictor for future pregnancy risk and management.

Study Design:

A retrospective cohort study of patients with a twin pregnancy complicated by HDP followed by a singleton pregnancy from 2011 to 2025. Participants were stratified by the presence or absence of SF during the index twin pregnancy. Maternal and neonatal outcomes in the subsequent singleton gestation were compared between groups.

Results:

The study population included 5,908 twin pregnancies, of them 577 (9.8%) were complicated by HDP and 82 had a subsequent singleton pregnancy. The recurrence rate of HDP was 18.3%. Recurrence was significantly higher in those with prior HDP and SF (36.7%) compared to those without prior SF (7.7%, p=0.001). Additionally, 27% of those with prior HDP and SF developed HDP with SF in the subsequent pregnancy, whereas none of the patients without prior SF did. HDP with SF in the index twin pregnancy was associated with a higher rate of adverse composite outcomes (46.7% vs. 21.2%, p=0.02), including placental abruption, fetal growth restriction, preterm labor, and recurrent HDP (Tables).

Conclusion:

A history of HDP with severe features in a twin pregnancy is associated with an increased risk of recurrence and adverse outcomes in a subsequent singleton gestation. In contrast, individuals with prior HDP without severe features had recurrence rates similar to the general population. These findings support incorporating HDP severity in twin pregnancies into counseling and risk stratification for future singleton pregnancies