Twin-twin transfusion syndrome: A population-based study
Twin-twin transfusion syndrome: A population-based study
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DOI：
10.1097/01.aog.0000143828.41271.6c
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发表时间：
2004-12-01
影响因子：
7.2
通讯作者：
Vincer, M
中科院分区：
文献类型：
--
作者：
Lutfi, S;Allen, VM;Vincer, M
目的：为了研究双胞胎输血综合征的发病率和死亡率和发病率在一个完整的人口为基础的队列在新斯科舍省方法：一个人口为基础的队列研究，所有单绒毛膜双胎妊娠20周或更长的出生新斯科舍省（加拿大）的居民在1988年和2000年之间进行了检查。研究了胎龄调整和出生体重不一致超过20%对死亡率和1年生存率的影响。其他研究结果包括出生抑郁症，呼吸窘迫综合征，慢性肺病，室间出血，脑室周围白质软化症，急性肾功能衰竭，充血性heartfailure.Results：404 monochoronic-diamniotic双胎妊娠检查，48被确定为双胞胎输血综合征。双胎输血综合征组每次妊娠的总死亡率显著高于其他单绒毛膜双羊膜腔病组（P <0.01）。然而，当调整胎龄时，死亡率未能达到统计学意义。同样，胎龄调整后，活产婴儿的1年生存率和其他结局无差异。出生体重的不一致预测每怀孕的发病率较高的病态结果，但这种影响是失去了孕龄adjustment.CONCLUSION：双胞胎双胞胎输血综合征的发病率和死亡率增加可能是由于早产的发病率较高。在控制胎龄和双胎输血综合征后，出生体重不一致并不是死亡率的独立预测因素。(C)2004年由美国妇产科医师学会。
OBJECTIVE: To study the incidence and mortality and morbidity rates of twin-twin transfusion syndrome in a complete population-based cohort in Nova Scotia.METHODS: A population-based cohort study of all monochorionic diamniotic twin pregnancies of 20 weeks of gestation or longer born to Nova Scotia (Canada) residents between 1988 and 2000 was examined. ne effect of gestational age adjustment and birth weight discordancy of more than 20% on mortality and 1-year survival was studied. Other outcomes studied included birth depression, respiratory distress syndrome, chronic lung disease, interventricular hemorrhage, periventricular leukomalacia, acute renal failure, and congestive heart failure.RESULTS: Of 404 monochorionic-diamniotic twin pregnancies examined, 48 were identified with twin-twin transfusion syndrome. Total mortality rates per pregnancy were significantly greater in the twin-twin transfusion syndrome group than in the remainder of our monochorionic diamniotic population (P < .01). However, when adjusted for gestational age, mortality failed to achieve statistical significance. Similarly, no differences were noted for 1-year survival and other outcomes of liveborn infants after gestational age adjustment. Discordance in birth weight predicted a higher incidence of morbid outcomes per pregnancy, but this effect was lost after gestational age adjustment.CONCLUSION: Increased morbidity and mortality of twins with twin-twin transfusion syndrome is likely to be due to a higher incidence of preterm birth. Birth weight discordancy was not found to be an independent predictor of mortality after controlling for gestational age and twin-twin transfusion syndrome. (C) 2004 by The American College of Obstetricians and Gynecologists.