Blondel B
INSERM U953, Unité de recherche épidémiologique sur la santé périnatale et la santé des femmes et des enfants, 94805 Villejuif cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2009 Dec;38(8 Suppl):S7-17. doi: 10.1016/S0368-2315(09)73555-0.
To describe trends in twin maternity rates, factors which contribute to these trends, and risks associated with twin maternities for mothers and children.
The review was done on population-based studies, preferably in France and the European Union.
The rate of twin maternities was 15.6 p 1000 in 2008 and it increased by about 80% between 1972 and 2006. This rise was explained mainly by advanced maternal age and the diffusion of fertility treatments. The major risks for twins were fetal and infant mortality, preterm delivery, small for gestational age, and cerebral palsy. The rate of preterm delivery (<37 weeks) was 44.3% in France in 2003, and the relative risk was 8.8 (95% CI: 7.8-10.0), when compared with single pregnancies. Maternal age and fertility treatments do not change very much the perinatal risk of twins.
Twin pregnancies are a high risk group which needs more intensive medical care than single pregnancies. The perinatal information system should be improved in France to monitor perinatal indicators according to the number of fetuses in a proper way.
描述双胎妊娠率的趋势、导致这些趋势的因素以及双胎妊娠对母亲和儿童的相关风险。
该综述基于人群研究进行，最好是在法国和欧盟开展的研究。
2008年双胎妊娠率为每1000例中有15.6例，在1972年至2006年间增长了约80%。这种增长主要归因于母亲年龄增大和辅助生殖技术的普及。双胎面临的主要风险包括胎儿和婴儿死亡率、早产、小于胎龄儿以及脑瘫。2003年法国的早产率（<37周）为44.3%，与单胎妊娠相比，相对风险为8.8（95%置信区间：7.8 - 10.0）。母亲年龄和辅助生殖技术对双胎围产期风险的影响变化不大。
双胎妊娠是一个高危群体，比单胎妊娠需要更强化的医疗护理。法国应改进围产期信息系统，以便以适当方式根据胎儿数量监测围产期指标。
