Zhang Xiao-Hui, Qiu Li-Qian, Huang Jiang-Ping
Deparment Of Women's Health, Women's Hospital School Of Medicine, Zhejiang University, No. 1 Xueshi Road, Hangzhou, Zhejiang, People's Republic of China.
Birth Defects Res A Clin Mol Teratol. 2011 Jan;91(1):34-8. doi: 10.1002/bdra.20725. Epub 2010 Oct 1.
Previous studies inconsistently suggest that there may be an association between birth defects and multiple births.
Data were obtained from Zhejiang Hospital-Based Birth Defects Surveillance System during 2007 to 2009. There was a total of 545,018 pregnancies, including 537,593 singleton pregnancies, and 7425 multiple pregnancies (14,606 twins and 366 triplets). Odds ratio (OR)and confidence interval (CI) for birth defects were calculated for the singletons and multiple births.
The rate of birth defects in multiple births was 444.16 per 10,000 births versus 266.97 per 10,000 births in singletons (OR, 1.69; 95% CI, 1.57-1.84). A significant risk of birth defects was observed in 9 of 23 categories in multiple births. Both the multiple births and singletons with birth defects exhibited a similar proportion of single malformation, male children, and the mother living in a city. The multiple births with birth defects were delivered earlier (t = 7.90, p < 0.001) at a lower birth weight (t = 17.53, p < 0.001) compared to singletons with birth defects. The proportion of an antenatal diagnosis was higher in singletons compared with multiple births (p < 0.001). The multiple births with birth defects had a higher proportion of live birth and early neonatal death (p < 0.001).
An increased risk of birth defects in multiple births compared with singletons was confirmed.
既往研究结果不一，提示出生缺陷与多胎妊娠之间可能存在关联。
数据来源于2007年至2009年浙江省医院出生缺陷监测系统。共有545,018例妊娠，其中包括537,593例单胎妊娠和7425例多胎妊娠（14,606例双胎妊娠和366例三胎妊娠）。计算单胎妊娠和多胎妊娠出生缺陷的比值比（OR）和置信区间（CI）。
多胎妊娠的出生缺陷发生率为每10,000例出生中有444.16例，而单胎妊娠为每10,000例出生中有266.97例（OR为1.69；95%CI为1.57 - 1.84）。在多胎妊娠的23个类别中有9个观察到出生缺陷的显著风险。有出生缺陷的多胎妊娠和单胎妊娠在单一畸形、男性儿童以及母亲居住在城市方面的比例相似。与有出生缺陷的单胎妊娠相比，有出生缺陷的多胎妊娠分娩时间更早（t = 7.90，p < 0.001），出生体重更低（t = 17.53，p < 0.001）。单胎妊娠产前诊断的比例高于多胎妊娠（p < 0.001）。有出生缺陷的多胎妊娠活产和早期新生儿死亡的比例更高（p < 0.001）。
证实多胎妊娠出生缺陷的风险高于单胎妊娠。
