Li Si-Jia, Ford Nancy, Meister Karen, Bodurtha Joann
Department of Human Genetics, School of Medicine, Virginia Commonwealth University, Richmond, Virginia 23298-0033, USA.
Birth Defects Res A Clin Mol Teratol. 2003 Oct;67(10):879-85. doi: 10.1002/bdra.10093.
Multiple births are increasing, and may be associated with birth defects.
To explore this relationship, data from the Virginia birth defects registry (VaCARES) was analyzed.
During 1989-1998, a total of 44505 children from singleton births and 2258 children from multiple births were born with birth defects in Virginia. The risk of birth defects was significantly increased in children from multiple births as compared to singleton births (birth defect rate per 10000 live births: singleton 482.3, twin 922.0, triplet 1300.0, and quadruplet or higher 2222.2). Increased risk was observed for 39 of 86 diagnoses. The five diagnoses with the highest risk ratio per 10000 live births (RR) were: neurofibromatosis (RR, 12.80), retrolental fibroplasia (RR, 9.96), microphthalmos (RR, 5.24), pulmonary valve anomalies (RR, 5.00), and patent ductus arteriosus (RR, 4.68). A significantly reduced risk ratio for congenital hip dislocation was found in these children (RR, 0.54). In most multiple births, only one child was born with birth defects (81% in twin births, 71% in triplet births, and 56% in quadruplet and higher births). The diagnosis of birth defects might be concordant or discordant for children in which all siblings had birth defects. The children from multiple births who had birth defects were generally preterm and had significantly lower birth weight. A higher fatality and mortality rate and longer hospital stay were also observed.
Overall, children from multiple births have an increased risk of birth defects.
多胞胎数量正在增加，且可能与出生缺陷有关。
为探究这种关系，对弗吉尼亚出生缺陷登记处（VaCARES）的数据进行了分析。
在1989年至1998年期间，弗吉尼亚共有44505名单胎出生的儿童和2258名多胞胎出生的儿童患有出生缺陷。与单胎出生的儿童相比，多胞胎出生儿童的出生缺陷风险显著增加（每10000例活产儿的出生缺陷率：单胎482.3，双胞胎922.0，三胞胎1300.0，四胞胎及以上2222.2）。在86种诊断中有39种观察到风险增加。每10000例活产儿中风险比（RR）最高的五种诊断为：神经纤维瘤病（RR，12.80）、晶状体后纤维增生症（RR，9.96）、小眼畸形（RR，5.24）、肺动脉瓣异常（RR，5.00）和动脉导管未闭（RR，4.68）。在这些儿童中发现先天性髋关节脱位的风险比显著降低（RR，0.54）。在大多数多胞胎中，只有一名儿童患有出生缺陷（双胞胎出生中占81%，三胞胎出生中占71%，四胞胎及以上出生中占56%）。对于所有兄弟姐妹都有出生缺陷的儿童，出生缺陷的诊断可能一致或不一致。患有出生缺陷的多胞胎出生儿童通常早产，出生体重显著较低。还观察到更高的病死率和死亡率以及更长的住院时间。
总体而言，多胞胎出生的儿童出生缺陷风险增加。
