Taylor Catherine L, de Groot Jan, Blair Eve M, Stanley Fiona J
Center for Developmental Health, Curtin University of Technology, and the Telethon Institute for Child Health Research, Perth, Western Australia.
Am J Obstet Gynecol. 2009 Jul;201(1):41.e1-6. doi: 10.1016/j.ajog.2009.02.003. Epub 2009 Apr 26.
This study investigated the risks for cerebral palsy in survivors of multiple pregnancies with cofetal loss (< 20 weeks' gestation) or cofetal death (>or= 20 weeks' gestation).
The total Western Australian population-based case-control study included 741 cases of cerebral palsy.
Antenatal cofetal loss or death occurred in 3% of all cases of cerebral palsy, which is a small but significant contribution. The odds ratio for cerebral palsy in survivors of cofetal loss that included iatrogenic pregnancy reduction was 2.65 (95% confidence interval [CI], 0.78-8.98), which gave a population-attributable proportion of 7.28% (95% CI, 0-27.5), compared with 4.25 (95% CI, 1.12-16.10) and 10.6% (95% CI, 1.0-35.6) for survivors of cofetal death.
This study quantifies the contribution of cofetal death to cerebral palsy and suggests that cofetal loss makes a similar, although somewhat smaller, contribution to the risk for cerebral palsy in survivors of multiple pregnancies.
本研究调查了双胎或多胎妊娠中伴发胎儿丢失（妊娠<20周）或胎儿死亡（妊娠≥20周）的幸存者发生脑瘫的风险。
这项基于西澳大利亚州总人口的病例对照研究纳入了741例脑瘫病例。
在所有脑瘫病例中，3%发生了产前胎儿丢失或死亡，这一比例虽小，但具有显著意义。在包括医源性减胎术在内的胎儿丢失幸存者中，脑瘫的比值比为2.65（95%置信区间[CI]，0.78 - 8.98），人群归因比例为7.28%（95%CI，0 - 27.5），相比之下，胎儿死亡幸存者的比值比为4.25（95%CI，1.12 - 16.10），人群归因比例为10.6%（95%CI，1.0 - 35.6）。
本研究量化了胎儿死亡对脑瘫的影响，并表明胎儿丢失对多胎妊娠幸存者发生脑瘫的风险贡献相似，尽管略小。
