Tobe Ruoyan Gai, Mori Rintaro, Shinozuka Norio, Kubo Takahiko, Itabashi Kazuo
Department of Global Health Policy, the University of Tokyo, Japan.
Twin Res Hum Genet. 2010 Oct;13(5):490-4. doi: 10.1375/twin.13.5.490.
Our aims were to assess the incidence of birthweight discordance of twins, to explore risk factors and its impact on perinatal mortality, and to quantify the risks at different severity of birthweight discordance in Japan, by using a nationwide obstetric database. There were 10,828 pairs of twins, born from 2001 to 2005 recorded in the database of the national Perinatal Health Care Project, fully enrolled. The overall incidence of birthweight discordance was 47.34%. The incidence of mild, severe and extremely severe discordance was 19.26%, 10.21% and 17.87%, respectively. The incidence of birthweight discordance in Japan is much higher than that in other countries, particularly at higher severity level. By linear regression model, our study added independent factors of primiparity (p < .001), sex composition (p < .001), chorionicity (p < .001), gestational age (p < .001), and delivery mode (p < .001) in determining birthweight discordance percentage. Maternal age and application of assisted reproduction technologies (ART) didn't significantly influence the birthweight discordance. The birthweight discordance is closely associated with gestational age and affected discharge mortality. From 25% of birthweight discordance, risk to discharge mortality tended to significantly increase, suggesting it should be added as a reference for clinical practices.
我们的目的是通过使用一个全国性的产科数据库，评估日本双胞胎出生体重不一致的发生率，探讨其危险因素及其对围产期死亡率的影响，并量化不同严重程度的出生体重不一致的风险。全国围产期保健项目数据库记录了2001年至2005年出生的10828对双胞胎，全部纳入研究。出生体重不一致的总体发生率为47.34%。轻度、重度和极重度不一致的发生率分别为19.26%、10.21%和17.87%。日本出生体重不一致的发生率远高于其他国家，尤其是在更高严重程度水平上。通过线性回归模型，我们的研究在确定出生体重不一致百分比时增加了初产（p <.001）、性别构成（p <.001）、绒毛膜性（p <.001）、孕周（p <.001）和分娩方式（p <.001）等独立因素。产妇年龄和辅助生殖技术（ART）的应用对出生体重不一致没有显著影响。出生体重不一致与孕周密切相关，并影响出院死亡率。从出生体重不一致达到25%起，出院死亡风险趋于显著增加，这表明应将其作为临床实践的参考依据。
