Prevalence and outcomes of twin pregnancies in Botswana: a national birth outcomes surveillance study.
Prevalence and outcomes of twin pregnancies in Botswana: a national birth outcomes surveillance study.
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DOI：
10.1136/bmjopen-2020-047553
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发表时间：
2021-10-21
期刊：
影响因子：
2.9
通讯作者：
Zash R
中科院分区：
文献类型：
--
作者：
Isaacson A;Diseko M;Mayondi G;Mabuta J;Davey S;Mmalane M;Makhema J;Jacobson DL;Luckett R;Shapiro RL;Zash R
本研究旨在评估博茨瓦纳双胞胎妊娠的患病率和结局。TSepamo研究从2014年8月到2018年6月在8家公立医院(约占博茨瓦纳所有新生儿的45%)进行了出生结果监测，并从2018年7月到2019年3月扩大到18家医院(约占博茨瓦纳所有新生儿的70%)。收集了所有胎龄(GA)大于24周的活产和死产住院分娩的数据。这项分析包括119 477名妇女在2014年8月至2019年3月期间出生的117 593名独生子女和3718名双胞胎婴儿(1859名(1.6%))，排除了73名较高阶数的婴儿(23名三胞胎和1名四胞胎)。我们的主要结局是早产(胎龄37周)、极早产(胎龄32周)和死产(APGAR(外表、脉搏、鬼脸、活动、呼吸)评分0，0，0)。双胞胎孕妇的产前检查次数中位数相似(9次比10次)，但更有可能在三级中心分娩(54.8%比45.1%，p<；0.001)，更有可能进行剖腹产(54.6%比22.0%，p<；0.001)。与单胎相比，双胞胎早产(+lt；37周)(47.6%比16.7%，调整后风险比(ARR)2.8，95%可信区间2.7~2.9)和极早产(<；32周)(11.8%比4.0%，ARR 3.0 95%CI 2.6~3.4)均高于单胎。在所有双胞胎妊娠中，128例(6.9%)至少有一个死胎，而单胎死产2845例(2.4%)(ARR2.8，95%可信区间2.3至3.3)。在博茨瓦纳的双胞胎中，不良分娩结局很常见，而且往往是严重的。能够更早识别双胞胎妊娠和改善双胎妊娠产前管理的干预措施可能会提高婴儿和儿童的存活率。
This study aims to evaluate the prevalence and outcome of twin pregnancies in Botswana. The Tsepamo Study conducted birth outcomes surveillance at 8 government-run hospitals (~45% of all births in Botswana) from August 2014 to June 2018 and expanded to 18 hospitals (~70% of all births in Botswana) from July 2018 to March 2019. Data were collected for all live-born and stillborn in-hospital deliveries with a gestational age (GA) greater than 24 weeks. This analysis included 117 593 singleton and 3718 twin infants (1859 sets (1.6%)) born to 119 477 women between August 2014 and March 2019 and excluded 73 higher order multiples (23 sets of triplets and 1 set of quadruplets). Our primary outcomes were preterm delivery (<37 weeks GA), very preterm delivery (<32 weeks GA) and stillbirth (APGAR (Appearance, Pulse, Grimace, Activity, Respiration) score of 0, 0, 0). Women with twin pregnancies had a similar median number of antenatal care visits (9 vs 10), but were more likely to deliver in a tertiary centre (54.8% vs 45.1%, p<0.001) and more likely to have a cesarean-section (54.6% vs 22.0%, p<0.001) than women with singletons. Compared with singletons, twin pregnancies had a higher risk of preterm delivery (<37 weeks GA) (47.6% vs 16.7%, adjusted risk ratio (aRR) 2.8, 95% CI 2.7 to 2.9) and very preterm delivery (<32 weeks) (11.8% vs 4.0%, aRR 3.0 95% CI 2.6 to 3.4). Among all twin pregnancies, 128 (6.9%) had at least one stillborn infant compared with 2845 (2.4%) stillbirths among singletons (aRR 2.8, 95% CI 2.3 to 3.3). Adverse birth outcomes are common among twins in Botswana, and are often severe. Interventions that allow for earlier identification of twin gestation and improved antenatal management of twin pregnancies may improve infant and child survival.
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影响因子：
15.8
作者：
Hanson, Claudia;Munjanja, Stephen;Benova, Lenka
通讯作者：
Benova, Lenka
影响因子：
7.2
作者：
Bellizzi, Saverio;Sobel, Howard;Temmerman, Marleen
通讯作者：
Temmerman, Marleen
影响因子：
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作者：
Mogobe, Keitshokile Dintle;Tshiamo, Wananani;Bowelo, Motsholathebe
通讯作者：
Bowelo, Motsholathebe
影响因子：
34.3
作者：
Monden, Christiaan W. S.;Smits, Jeroen
通讯作者：
Smits, Jeroen
DOI：
10.1111/j.1471-0528.2012.03356.x
发表时间：
2012-07-01
影响因子：
5.8
作者：
Dodd, J. M.;Crowther, C. A.;Robinson, J. S.
通讯作者：
Robinson, J. S.