Nazer J, Cifuentes L, Bazzano M
Unidad de Neonatología, Hospital Clínico Universidad de Chile, Santiago, Chile.
Rev Med Chil. 1999 Feb;127(2):158-64.
A higher prevalence of congenital malformations among twins than among single has been reported in the literature.
To study the incidence of congenital malformations in twins in the maternity hospital of the University of Chile in the period 1983-1997.
As part of the Latin American Collaborative Study of Congenital Malformations, every newborn in the maternity hospital was examined by a neonatologist and congenital malformations were recorded in a special file.
In the study period there were 48.663 deliveries of single pregnancies and 448 deliveries of twin pregnancies, giving birth to 886 twins borns alive and 17 stillbirths (1.9% mortality). Of these, there were 423 twins, 17 triplets, a sextuple delivery and two siamese. Seven point one percent of twins born alive and 6.5% of single newborns had a congenital malformation. The prevalence of malformations in twins and single stillbirths was 35.2 and 17.2% respectively (p < 0.04). In four pairs and siamese newborns, malformations typical of monozygotic twins were present, such as an acardiac fetus with Trap sequence, a papyraceous fetus and two with hydroanencephaly. Twelve twins had malformations attributable to uterine compression.
This study did not find a higher frequency of malformations comparing twins with single babies born alive, but in stillbirths there was a significant difference between single and twin stillbirths (7.1% versus 35.2%, respectively, p < 0.05).
文献报道双胞胎先天性畸形的患病率高于单胎。
研究1983 - 1997年期间智利大学妇产医院双胞胎先天性畸形的发生率。
作为拉丁美洲先天性畸形协作研究的一部分,妇产医院的每一位新生儿均由新生儿科医生进行检查,并将先天性畸形记录在一份特殊档案中。
在研究期间,单胎妊娠分娩48663例,双胎妊娠分娩448例,共分娩出886例活产双胞胎和17例死产(死亡率1.9%)。其中,有423对双胞胎、17例三胞胎、1例六胞胎分娩和2例联体儿。7.1%的活产双胞胎和6.5%的单胎新生儿患有先天性畸形。双胞胎和单胎死产的畸形患病率分别为35.2%和17.2%(p < 0.04)。在4对双胞胎和联体儿新生儿中,存在典型的单卵双胞胎畸形,如无心畸胎合并联体序列、纸样胎儿以及2例积水性无脑儿。12对双胞胎有因子宫压迫导致的畸形。
本研究未发现活产双胞胎与单胎婴儿相比畸形发生率更高,但在死产中,单胎和双胎死产之间存在显著差异(分别为7.1%和35.2%,p < 0.05)。