Kinzler W L, Ananth C V, Vintzileos A M
Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal Fetal Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, 08903, USA.
J Soc Gynecol Investig. 2000 Nov-Dec;7(6):321-7.
To determine the incidence and trends of twinning in the United States and to review the medical and economic effects of twin versus singleton gestations.
Pertinent and recent studies on twin gestations were obtained through a MEDLINE database search of the English language between December 1987 and December 1999. Data from the 1995-1996 National Center for Health Statistics were also used to compare gestational age at delivery, fetal growth restriction, and perinatal mortality for twin and singleton gestations. Studies that have evaluated perinatal risks in relation to advanced reproductive technology also were reviewed and summarized. The economic implications of twinning from a societal perspective and infant quality of life issues of twins compared with singleton gestations are reviewed.
Due to delayed childbearing and increased use of reproductive technologies, the incidence of twin gestations in the United States has been increasing. Twin pregnancies have a higher risk of complications, including pregnancy-induced hypertension, anemia, antepartum and postpartum hemorrhage, and maternal mortality. In addition, twin infants are more likely to deliver preterm, have low birth weight and greater perinatal mortality rates. These outcomes influence health care costs and quality of life for both parents and children.
Women carrying twin fetuses are at increased risk for perinatal and obstetric complications. The increased perinatal risks that accompany twin fetuses may be partly due to the increasing use of advanced reproductive technologies. The economic burdens, as well as the potential for decreased quality of life among twins, needs careful evaluation.
确定美国双胎妊娠的发生率及趋势，并综述双胎妊娠与单胎妊娠相比的医学和经济影响。
通过检索1987年12月至1999年12月期间的MEDLINE英文数据库，获取有关双胎妊娠的相关近期研究。还使用了1995 - 1996年国家卫生统计中心的数据，以比较双胎妊娠和单胎妊娠的分娩孕周、胎儿生长受限情况及围产期死亡率。对评估与先进生殖技术相关的围产期风险的研究也进行了综述和总结。从社会角度综述了双胎妊娠的经济影响以及与单胎妊娠相比双胎婴儿的生活质量问题。
由于生育延迟和生殖技术使用增加，美国双胎妊娠的发生率一直在上升。双胎妊娠发生并发症的风险更高，包括妊娠高血压、贫血、产前和产后出血以及孕产妇死亡。此外，双胎婴儿更易早产、出生体重低且围产期死亡率更高。这些结果影响了父母和孩子的医疗保健成本及生活质量。
怀有双胎胎儿的女性发生围产期和产科并发症的风险增加。双胎胎儿伴随的围产期风险增加可能部分归因于先进生殖技术使用的增加。经济负担以及双胎生活质量可能下降的情况需要仔细评估。
