Hartley Rebecca S, Hitti Jane, Emanuel Irvin
Department of Biology, Seattle University, WA 98122, USA.
Am J Obstet Gynecol. 2002 Nov;187(5):1173-8. doi: 10.1067/mob.2002.126961.
The purpose of this study was to determine whether size-discordant twin pairs have worse perinatal mortality and neonatal morbidity rates than nondiscordant pairs and whether the smaller twins of discordant pairs have worse perinatal outcomes than the larger twins.
We conducted a population-based, retrospective analysis of linked birth certificates and fetal and infant death certificates for 9590 twin pairs who were born in the state of Washington from 1987 through 1999. The Cochran-Mantel-Haenszel test, Student t test, and McNemar test were among the tests used to assess statistical significance.
Discordant twin pairs had higher rates of perinatal mortality, neonatal mortality, and 5-minute Apgar scores of <7, even after stratification by gestational age. Discordant pairs had lower pair weights at each gestational age and were more likely to include small-for-gestational-age infants. Compared with the larger twins, the smaller twins of discordant pairs had higher rates of perinatal mortality.
Discordant pairs had worse perinatal outcomes within each gestational age category.
本研究旨在确定大小不一致的双胎妊娠与大小一致的双胎妊娠相比，围产期死亡率和新生儿发病率是否更高，以及大小不一致双胎中较小的胎儿与较大的胎儿相比，围产期结局是否更差。
我们对1987年至1999年在华盛顿州出生的9590对双胞胎的出生证明以及胎儿和婴儿死亡证明进行了基于人群的回顾性分析。所使用的评估统计学显著性的检验方法包括 Cochr an-Mantel-Haenszel检验、Student t检验和McNemar检验。
即使按孕周分层后，大小不一致的双胎妊娠的围产期死亡率、新生儿死亡率以及5分钟阿氏评分<7的发生率仍较高。在每个孕周，大小不一致的双胎体重较低，且更有可能包含小于胎龄儿。与较大的胎儿相比，大小不一致双胎中较小的胎儿围产期死亡率更高。
在每个孕周类别中，大小不一致双胎的围产期结局更差。
