{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T18:58:02Z","timestamp":1786993082499,"version":"build-2736575974"},"reference-count":28,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T00:00:00Z","timestamp":1739491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012285","name":"BC Children's Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012285","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005247","name":"University of British Columbia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005247","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jogc.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Obstetrics and Gynaecology Canada"],"published-print":{"date-parts":[[2025,4]]},"DOI":"10.1016\/j.jogc.2025.102792","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T13:10:51Z","timestamp":1739884251000},"page":"102792","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Twin Birth and Hemolysis, Elevated Liver Enzymes, and Low Platelets (HELLP) Syndrome: A Population-Based Study"],"prefix":"10.1016","volume":"47","author":[{"given":"Sofia","family":"Nicolls","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li Qing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Koegl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Lyons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Van Schalkwyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.S.","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1220-310X","authenticated-orcid":false,"given":"Sarka","family":"Lisonkova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jogc.2025.102792_bib1","series-title":"Williams obstetrics","author":"Cunningham","year":"2018"},{"key":"10.1016\/j.jogc.2025.102792_bib2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/AOG.0000000000000564","article-title":"Pregnancy-related mortality in the United States, 2006\u20132010","volume":"125","author":"Creanga","year":"2015","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.jogc.2025.102792_bib3","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/S0140-6736(06)68397-9","article-title":"WHO analysis of causes of maternal death: a systematic review","volume":"367","author":"Khan","year":"2006","journal-title":"Lancet"},{"key":"10.1016\/j.jogc.2025.102792_bib4","doi-asserted-by":"crossref","first-page":"2101","DOI":"10.1111\/j.1523-1755.2005.00316.x","article-title":"Preeclampsia: a renal perspective","volume":"67","author":"Karumanchi","year":"2005","journal-title":"Kidney Int"},{"key":"10.1016\/j.jogc.2025.102792_bib5","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1111\/j.1471-0528.1997.tb14346.x","article-title":"The HELLP syndrome","volume":"104","author":"Geary","year":"1997","journal-title":"Br J Obstet Gynaecol"},{"key":"10.1016\/j.jogc.2025.102792_bib6","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1038\/jp.2012.74","article-title":"Preterm severe preeclampsia in singleton and twin pregnancies","volume":"33","author":"Henry","year":"2013","journal-title":"J\u00a0Perinatol"},{"key":"10.1016\/j.jogc.2025.102792_bib7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.bpobgyn.2022.03.008","article-title":"Screening for preeclampsia in twin pregnancies","volume":"84","author":"Francisco","year":"2022","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"10.1016\/j.jogc.2025.102792_bib8","doi-asserted-by":"crossref","first-page":"B2","DOI":"10.1016\/j.ajog.2019.04.013","article-title":"SMFM Special Statement: state of the science on multifetal gestations: unique considerations and importance","volume":"221","author":"Grantz","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.jogc.2025.102792_bib9","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1093\/humrep\/deab029","article-title":"Twin Peaks: more twinning in humans than ever before","volume":"36","author":"Monden","year":"2021","journal-title":"Hum Reprod"},{"key":"10.1016\/j.jogc.2025.102792_bib10","first-page":"223","article-title":"Multiple births: trends and patterns in Canada, 1974\u20131990","volume":"4","author":"Millar","year":"1992","journal-title":"Health Rep"},{"key":"10.1016\/j.jogc.2025.102792_bib11","author":"Cochrane"},{"key":"10.1016\/j.jogc.2025.102792_bib12","author":"Perinatal services"},{"key":"10.1016\/j.jogc.2025.102792_bib13","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s12884-015-0563-7","article-title":"Validating the British Columbia Perinatal Data Registry: a chart re-abstraction study","volume":"15","author":"Frosst","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"10.1016\/j.jogc.2025.102792_bib15","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.ajog.2021.04.261","article-title":"Incidence and risk factors for severe preeclampsia, hemolysis, elevated liver enzymes, and low platelet count syndrome, and eclampsia at preterm and term gestation: a population-based study","volume":"225","author":"Lisonkova","year":"2021","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.jogc.2025.102792_bib16","series-title":"Obesity and overweight","year":"2021"},{"key":"10.1016\/j.jogc.2025.102792_bib17","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1001\/jama.2017.16191","article-title":"Association between prepregnancy body mass index and severe maternal morbidity","volume":"318","author":"Lisonkova","year":"2017","journal-title":"JAMA"},{"key":"10.1016\/j.jogc.2025.102792_bib18","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1038\/s41366-023-01320-6","article-title":"Pre-pregnancy body mass index and adverse maternal and perinatal outcomes in twins: a population retrospective cohort study","volume":"47","author":"Bone","year":"2023","journal-title":"Int J Obes (Lond)"},{"key":"10.1016\/j.jogc.2025.102792_bib19","series-title":"Multiple imputation for nonresponse in surveys","author":"Rubin","year":"1987"},{"key":"10.1016\/j.jogc.2025.102792_bib20","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1093\/oxfordjournals.aje.a009400","article-title":"Comparison of risk factors for preeclampsia and gestational hypertension in a population-based cohort study","volume":"147","author":"Ros","year":"1998","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.jogc.2025.102792_bib21","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1056\/NEJMoa031884","article-title":"Circulating angiogenic factors and the risk of preeclampsia","volume":"350","author":"Levine","year":"2004","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.jogc.2025.102792_bib22","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ejogrb.2012.09.026","article-title":"Pathogenesis of the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP): a review","volume":"166","author":"Abildgaard","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"10.1016\/j.jogc.2025.102792_bib23","first-page":"389","article-title":"HELLP syndrome and placental inflammatory pathology","volume":"60","author":"Landi","year":"2008","journal-title":"Minerva Ginecol"},{"key":"10.1016\/j.jogc.2025.102792_bib24","article-title":"Prepregnancy body mass index and other risk factors for early-onset and late-onset haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome: a population-based retrospective cohort study in British Columbia, Canada","volume":"14","author":"Wang","year":"2024","journal-title":"BMJ Open"},{"key":"10.1016\/j.jogc.2025.102792_bib25","series-title":"StatPearls. Treasure Island (FL)","article-title":"HELLP syndrome","author":"Khalid","year":"2024"},{"key":"10.1016\/j.jogc.2025.102792_bib27","series-title":"The daily \u2014 births","year":"2019"},{"key":"10.1016\/j.jogc.2025.102792_bib28","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1097\/01.AOG.0000126245.35811.2a","article-title":"Diagnosis, controversies, and management of the syndrome of hemolysis, elevated liver enzymes, and low platelet count","volume":"103","author":"Sibai","year":"2004","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.jogc.2025.102792_bib29","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/0002-9378(90)90376-I","article-title":"The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): much ado about nothing?","volume":"162","author":"Sibai","year":"1990","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.jogc.2025.102792_bib30","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s10995-013-1307-9","article-title":"Descriptive epidemiology of chronic hypertension, gestational hypertension, and preeclampsia in New York State, 1995\u20132004","volume":"18","author":"Savitz","year":"2014","journal-title":"Matern Child Health J"}],"container-title":["Journal of Obstetrics and Gynaecology Canada"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1701216325000325?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1701216325000325?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T22:53:22Z","timestamp":1762556002000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1701216325000325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["S1701216325000325"],"URL":"https:\/\/doi.org\/10.1016\/j.jogc.2025.102792","relation":{},"ISSN":["1701-2163"],"issn-type":[{"value":"1701-2163","type":"print"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Twin Birth and Hemolysis, Elevated Liver Enzymes, and Low Platelets (HELLP) Syndrome: A Population-Based Study","name":"articletitle","label":"Article Title"},{"value":"Journal of Obstetrics and Gynaecology Canada","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jogc.2025.102792","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author. Published by ELSEVIER INC. on behalf of The Society of Obstetricians and Gynaecologists of Canada\/La Soci\u00e9t\u00e9 des obst\u00e9triciens et gyn\u00e9cologues du Canada.","name":"copyright","label":"Copyright"}],"article-number":"102792"}}