Gielen Marij, Lindsey Patrick J, Derom Catherine, Loos Ruth J F, Derom Robert, Nijhuis Jan G, Vlietinck Robert
Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Department of Population Genetics, Genomics and Bioinformatics, Maastricht University, Maastricht, the Netherlands.
Twin Res Hum Genet. 2006 Oct;9(5):664-72. doi: 10.1375/183242706778553471.
The purpose of this study is to present curves of estimated placental growth in twins and to evaluate the relative contribution of gestational age, zygosity, chorionicity, fusion of the placentas, sex of the individual and of the twin pair, site of the umbilical cord insertion, birth order, maternal age, and parity. Perinatal data and placental data were obtained from 6315 live-born twin pairs from the East Flanders Prospective Twin Survey. Of 4318 twin pairs, with no missing values, the placental weights of different gestational ages were analyzed using a nonlinear multivariate Gaussian regression. Two groups were distinguished: (1) twins with two separate placentas, and (2) twins with only one placental mass (one placenta in case of monochorionic twins or two fused placentas in case of dichorionic placentas). Overall, placental weight was influenced by gestational age, fusion of the placentas, and parity. In the case of one placental mass, monozygotic dichorionic twins had the lowest weights. If two separate placentas were present, birth order played a role in favor of the first-born twin. For parity and zygosity, the differences were most pronounced between 27 and 29 weeks, whereas the difference for birth order was most pronounced between 33 and 37 weeks. In conclusion, basic physiological characteristics, routinely examined at birth, influence placental weight. Taking these covariates into account allows a better evaluation of the placental weight given a gestational age, as an indicator of growth.
本研究的目的是呈现双胞胎胎盘估计生长曲线,并评估胎龄、合子性、绒毛膜性、胎盘融合、个体及双胞胎对的性别、脐带插入部位、出生顺序、母亲年龄和产次的相对贡献。围产期数据和胎盘数据来自东佛兰德前瞻性双胞胎调查中的6315例活产双胞胎对。在4318例无缺失值的双胞胎对中,使用非线性多变量高斯回归分析不同胎龄的胎盘重量。分为两组:(1)有两个独立胎盘的双胞胎,(2)只有一个胎盘块的双胞胎(单绒毛膜双胞胎为一个胎盘,双绒毛膜双胞胎为两个融合胎盘)。总体而言,胎盘重量受胎龄、胎盘融合和产次影响。在只有一个胎盘块的情况下,单卵双绒毛膜双胞胎的胎盘重量最低。如果有两个独立胎盘,出生顺序对第一个出生的双胞胎有利。对于产次和合子性,差异在27至29周时最为明显,而出生顺序的差异在33至37周时最为明显。总之,出生时常规检查的基本生理特征会影响胎盘重量。考虑这些协变量可以在给定胎龄的情况下更好地评估胎盘重量,作为生长的指标。