Yokoyama Yoshie, Sugimoto Masako, Miyake Yu, Sono Jun, Mizukami Kenge, Kaprio Jaakko, Silventoinen Karri
Department of Community Health Nursing, Osaka City University, Japan.
Twin Res Hum Genet. 2011 Apr;14(2):185-91. doi: 10.1375/twin.14.2.185.
We analyzed whether motor development in early life is different between singletons and triplets in Japan. The motor development was reported by mothers by postal questionnaire for 1,121 triplet children and in regular health check-ups for 13,906 singleton children. Children who were suspected of having neurological abnormality or disability were excluded from the analysis. The ages of milestone achievements were significantly higher in triplets for each outcome compared to singletons. Further, after adjustment for gestational age, birthweight, and birth length, the differences were significant for maintaining head, sitting alone and standing holding on. In children with birthweight of 2 kg or more, the ages of milestone achievements were significantly higher in triplets for each outcome compared to singletons, except walking holding on. Moreover, after adjustment for the confounding factors, the differences were significant for sitting alone and walking independently. On the contrary, singletons attained motor development facilitating crawling, walking holding on, and walking independently slower than triplets among those children with birthweight of 2 kg or less after adjustment for gestational age. In conclusion, triplets are overall at higher risk for the delay of gross motor milestones as compared to singletons independently of birth-related factors. In contrast, among children with a birthweight of less than 2 kg, singletons showed slower motor development than triplets after adjusting for gestational age. There is an obvious need to apply developmental standards that consider at least both multiple birth status (singleton, twin or triplet) and birthweight.
我们分析了日本单胎和三胞胎在生命早期的运动发育是否存在差异。通过邮寄问卷的方式，母亲们报告了1121名三胞胎儿童的运动发育情况，同时在常规健康检查中报告了13906名单胎儿童的运动发育情况。疑似患有神经异常或残疾的儿童被排除在分析之外。与单胎相比，三胞胎在每个发育里程碑达成的年龄均显著更高。此外，在对胎龄、出生体重和出生身长进行调整后，三胞胎在保持抬头、独坐和扶站方面的差异具有统计学意义。在出生体重2千克及以上的儿童中，与单胎相比，三胞胎在每个发育里程碑达成的年龄均显著更高，除了扶走。此外，在对混杂因素进行调整后，三胞胎在独坐和独立行走方面的差异具有统计学意义。相反，在对胎龄进行调整后，出生体重2千克及以下的儿童中，如果是单胎，其在促进爬行、扶走和独立行走的运动发育方面比三胞胎慢。总之，与单胎相比，三胞胎总体上在粗大运动发育里程碑延迟方面的风险更高，且独立于出生相关因素。相比之下，在出生体重低于2千克的儿童中，在对胎龄进行调整后，单胎的运动发育比三胞胎慢。显然有必要应用至少考虑多胎状况（单胎、双胞胎或三胞胎）和出生体重的发育标准。
