双胎与三胎及四胎妊娠的新生儿结局

The neonatal outcome in twin versus triplet and quadruplet pregnancies.

作者信息

Nasseri Fatemeh, Azhir Afshin

机构信息

Neonatologist, Assistant Professor of Pediatrics, Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:

出版信息

J Res Med Sci. 2009 Jan;14(1):7-12.

PMID:21772855

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3129073/

Abstract

BACKGROUND

To assess the risk of neonatal mortality and morbidity in twin, triplet and quadruplet pregnancies.

METHODS

In a retrospective study, the neonatal outcome of all twin, triplet and quadruplet gestations delivered from October 2001 to September 2006 was reviewed. The neonatal outcome of triples and quadruplets was compared with a matched group of twins for gestational age.

RESULTS

During a 5-year period, 511 sets of twin pregnancies, 42 sets of triplet and 5 sets of quadruplet pregnancies were studied. The mean of gestational age for twins, triplets and quadruplets were 33.92 ± 3.5 weeks, 30.92 ± 3.8 weeks and 31.60 ± 2.0 weeks, respectively, (P = 0.0001). Triplets and quadruplets weighed less than twins, (P = 0.0001). Neonatal mortality was 13.5% for twins, 26.8% for triplets and 30% for quadruplets. In vitro fertilization, use of ovulation induction agents, and cesarean delivery in the women with triplet and quadruplet were significantly higher than in those with twin pregnancies, (P = 0.0001). The mean age of mothers with triplets and quadruplets was significantly higher than with twins (P = 0.026). There was not a significant difference in respiratory and non-respiratory short outcomes between triplets, quadruplets and twins when matched for gestational age. Apgar score at 1 and 5 minutes was significantly lower in triplets and quadruplets than twins. There was no influence of birth order on neonatal mortality of triplet pregnancy. Neonatal mortality of triplet births was significantly decreased over the 5 years of the study period.

CONCLUSIONS

Triplets and quadruplets have a similar neonatal outcome as twins when matched for gestational age. There is no influence of birth on the neonatal mortality of triplet pregnancy. It appears that outcome is mainly dependent on gestational age.

摘要

背景

评估双胎、三胎及四胎妊娠新生儿死亡和发病的风险。

方法

在一项回顾性研究中，对2001年10月至2006年9月期间分娩的所有双胎、三胎及四胎妊娠的新生儿结局进行了回顾。将三胎和四胎的新生儿结局与一组匹配孕周的双胎进行比较。

结果

在5年期间，研究了511例双胎妊娠、42例三胎妊娠和5例四胎妊娠。双胎、三胎和四胎的平均孕周分别为33.92±3.5周、30.92±3.8周和31.60±2.0周，（P=0.0001）。三胎和四胎的体重低于双胎，（P=0.0001）。双胎的新生儿死亡率为13.5%，三胎为26.8%，四胎为30%。三胎和四胎孕妇的体外受精、促排卵药物使用及剖宫产率显著高于双胎孕妇，（P=0.0001）。三胎和四胎孕妇的平均年龄显著高于双胎孕妇（P=0.026）。在匹配孕周时，三胎、四胎和双胎之间的呼吸和非呼吸短期结局无显著差异。三胎和四胎1分钟和5分钟时的阿氏评分显著低于双胎。出生顺序对三胎妊娠的新生儿死亡率无影响。在研究的5年期间，三胎分娩的新生儿死亡率显著下降。