{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:17:47Z","timestamp":1768565867124,"version":"3.49.0"},"posted":{"date-parts":[[2023,11,11]]},"group-title":"Epidemiology","reference-count":36,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2023,11,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In singleton pregnancies, fetal sexual dimorphism has been observed in hypertensive disorders of pregnancy (HDP), particularly preeclampsia, a morbid syndrome that increases risk of adult onset cardiovascular disease for mothers and their offspring. However, few studies have explored the effect of fetal sex on HDP among twin pregnancies.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study of 1,032 twin pregnancies between 2011 - 2022 using data from a perinatal database that recruits participants from three hospitals in Houston, TX. We categorized pregnancies based on fetal sex pairings into female\/female, male\/male, and female\/male. Pregnancies with a female\/female fetal sex were used as our reference group. Our primary outcomes included gestational hypertension, preeclampsia, superimposed preeclampsia, and preeclampsia subtyped by gestational age of delivery. A modified Poisson regression model with robust error variance was used to calculate the relative risk (RR) and 95% confidence interval (CI) for the association between fetal sex pairs and HDP.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Adjusted models of female\/male fetal sex pairs were associated with preterm preeclampsia (RR 2.01, 95% CI 1.15-3.53) relative to those with female\/female fetuses. No associations with other HDP were observed among pregnancies with male\/male fetal sex compared to those with female\/female fetal sex pairs.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We found some evidence of sexual dimorphism for preterm preeclampsia among female\/male twin pairs. Additional research is needed to understand what biological mechanisms could explain these findings.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2023.11.10.23298403","type":"posted-content","created":{"date-parts":[[2023,11,12]],"date-time":"2023-11-12T01:35:13Z","timestamp":1699752913000},"source":"Crossref","is-referenced-by-count":0,"title":["Fetal sexual dimorphism and preeclampsia among twin pregnancies"],"prefix":"10.64898","author":[{"given":"Rebekah E.","family":"Brown","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2002-6147","authenticated-orcid":false,"given":"Akaninyene I.","family":"Noah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley V.","family":"Hill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8234-1815","authenticated-orcid":false,"given":"Brandie DePaoli","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2023111422450672000_2023.11.10.23298403v1.1","first-page":"1","article-title":"Births: Final Data for 2020","volume":"70","year":"2021","journal-title":"Natl Vital Stat Rep"},{"key":"2023111422450672000_2023.11.10.23298403v1.2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004397"},{"key":"2023111422450672000_2023.11.10.23298403v1.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-022-06623-z"},{"key":"2023111422450672000_2023.11.10.23298403v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/s0029-7844(03)00807-x"},{"key":"2023111422450672000_2023.11.10.23298403v1.5","doi-asserted-by":"publisher","DOI":"10.1111\/nure.12055"},{"key":"2023111422450672000_2023.11.10.23298403v1.6","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.14781"},{"key":"2023111422450672000_2023.11.10.23298403v1.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.385301.BE"},{"key":"2023111422450672000_2023.11.10.23298403v1.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2019.01.016"},{"key":"2023111422450672000_2023.11.10.23298403v1.9","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12562"},{"key":"2023111422450672000_2023.11.10.23298403v1.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2018.02.009"},{"key":"2023111422450672000_2023.11.10.23298403v1.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2016.05.005"},{"key":"2023111422450672000_2023.11.10.23298403v1.12","doi-asserted-by":"publisher","DOI":"10.1111\/aji.12303"},{"key":"2023111422450672000_2023.11.10.23298403v1.13","doi-asserted-by":"publisher","DOI":"10.1177\/1933719114537713"},{"key":"2023111422450672000_2023.11.10.23298403v1.14","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.12569"},{"key":"2023111422450672000_2023.11.10.23298403v1.15","unstructured":"Tanner LD . 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