PRETERM DISCORDANT TWINS - WHAT BIRTH-WEIGHT DIFFERENCE IS SIGNIFICANT
PRETERM DISCORDANT TWINS - WHAT BIRTH-WEIGHT DIFFERENCE IS SIGNIFICANT
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DOI：
10.1016/0002-9378(95)90027-6
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发表时间：
1995-03-01
影响因子：
9.8
通讯作者：
DASILVA, OP
中科院分区：
文献类型：
--
作者：
CHEUNG, VYT;BOCKING, AD;DASILVA, OP
目的：本研究的目的是确定不一致的胎儿生长对随后的围产期和新生儿结局的影响，不同程度的出生体重不一致的早产twin gestations.Study Design：122个活产双胞胎之间的25和34完成周的妊娠进行了回顾性研究。根据婴儿出生体重的百分比差异将其分为五类：<10%，10%至15%，15%至20%，20%至30%和> 30%，其定义为（[较大双胞胎的出生体重-较小双胞胎的出生体重]/较大双胞胎的出生体重）× 100。确定不同出生体重类别与围产期和新生儿结局之间的关系以及每个类别中大婴儿和小婴儿之间结局的差异。出生体重差异> 30%的早产双胎妊娠与较高的婴儿死亡率（25%）、先天性畸形（37.5%）、小于胎龄儿（31.8%）、5分钟Apgar评分< 7分（33.3%）和脑室周围白质软化（16.7%），尽管剖宫产率较高（79.2%）。结果的大，小婴儿类别内是相似的，除了在> 30%组，所有的死亡发生在小infants.CONCLUSION：在早产双胎妊娠中使用30%的出生体重差异，以定义双胞胎不一致性是最临床相关的，在确定那些婴儿的风险，不良围产期结局。
OBJECTIVE: The purpose of this study was to determine the effect of discordant fetal growth on subsequent perinatal and neonatal outcome for different degrees of birth weight discordance in preterm twin gestations.STUDY DESIGN: One hundred twenty-two live born twin sets delivered between 25 and 34 completed weeks' gestation were retrospectively studied. They were stratified into five categories according to the percent difference in infant birth weight: < 10%, 1O% to 15%, 15% to 20%, 20% to 30%, and > 30%, which was defined as ([Birth weight of larger twin - Birth weight of smaller twin]/Birth weight of larger twin) x 100. The relationship between different birth weight categories and the perinatal and neonatal outcome and the difference in outcome between the large and small infants within each category were determined.RESULTS: Preterm twin gestations with > 30% birth weight discordance were associated with a higher incidence of infant death (25%), congenital anomalies (37.5%), small-for-gestational-age infants (31.8%), Apgar score < 7 at 5 minutes (33.3%), and periventricular leukomalacia (16.7%), in spite of a higher cesarean delivery rate (79.2%). Outcomes of large and small infants within categories were similar except in the > 30% group, where all deaths occurred in the small infants.CONCLUSION: In preterm twin gestations the use of a 30% birth weight difference to define twin discordance is most clinically relevant in identifying those infants at risk for adverse perinatal outcome.