Advanced maternal age and fetal growth inhibition in triplets.
Advanced maternal age and fetal growth inhibition in triplets.
复制标题
高龄产妇和三胞胎胎儿生长抑制。
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
G. Alexander
中科院分区：
文献类型：
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作者：
H. Salihu;S. Bagchi;Z. Aliyu;R. Kirby;G. Alexander
目的
确定高龄产妇是否与三胞胎胎儿生长抑制有关。
研究设计
我们对美国1995年至1998年的三胞胎活产进行了回顾性队列研究。测量的胎儿生长抑制结局为低出生体重、极低出生体重、早产、极早产和小于胎龄儿。我们使用广义估计方程框架，考虑到集群内的相关性后，产生调整后的OR。
结果
与年轻产妇年龄（20-29岁）相比，成熟（30-39岁）和年龄较大（≥ 40岁）的三胎妊娠妇女胎儿生长抑制的可能性较低。平均出生体重和分娩时的平均胎龄随着母体年龄的增加而增加，呈剂量依赖性模式（趋势p < 0.0001）。与年轻母亲所生的三胞胎相比，年龄较大的母亲所生的三胞胎不太可能有低出生体重（OR=0.51，95%CI =0.37-0.69）或极低出生体重（OR = 0.58，95%CI = 0.47-0.72）或早产（OR = 0.39，95%CI = 0.27-0.56）或极早产（OR = 0.67，95%CI = 0.55-0.80）。小于胎龄儿的风险是相似的。
结论
高龄产妇与更有利的三胞胎胎儿生长参数相关，尽管这种矛盾的确切机制仍知之甚少。
OBJECTIVE
To determine whether advanced maternal age is associated withfetal growth inhibition in triplets.
STUDY DESIGN
We conducted a retrospective cohort study on triplet live births in the United States from 1995 through 1998. The outcomes of fetal growth inhibition measured were low birth weight, very low birth weight, preterm birth, very preterm birth and smallnessfor gestational age. We generated adjusted ORs after taking into account intracluster correlations using the generalized estimating equation framework.
RESULTS
As compared to women of younger maternal age (20-29), mature (30-39) and older women (> or =40 years) with triplet gestations tended to have a lower likelihood offetal growth inhibition. Mean birth weight and mean gestational age at delivery increased with increasing maternal age in a dose-dependent pattern (p for trend < 0.0001). As compared to triplets born to younger mothers, those of older women were less likely to have low birth weight (OR=0.51, 95% CI=0.37-0.69) or very low birth weight (OR = 0.58, 95% CI = 0.47-0.72) or to be preterm (OR = 0.39, 95% CI = 0.27-0.56) or very preterm (OR = 0.67, 95% CI = 0.55-0.80). The riskfor small-for-gestational-age infants was comparable.
CONCLUSION
Older maternal age is associated with morefavorable triplet fetal growth parameters, although the exact mechanisms of this paradox remain poorly understood.