Spellacy W N, Handler A, Ferre C D
Department of Obstetrics and Gynecology, College of Medicine, University of Illinois, Chicago.
Obstet Gynecol. 1990 Feb;75(2):168-71.
In one regional perinatal network between 1982-1987, 101,506 women delivered infants greater than 500 g, of which 1253 were twin pregnancies (1.2%). This latter group was compared statistically with a 5% random sample of the singletons (N = 5119). The results showed that the women with twin pregnancies were slightly older, had a higher parity, gained more weight during the gestation, and had a heavier body weight at delivery. Twin pregnancies were complicated by increases in hypertension (odds ratio 2.5; 95% confidence interval 2.1-3.1), abruption (odds ratio 3.0; 95% confidence interval 1.9-4.7), and anemia (odds ratio 2.4; 95% confidence interval 1.9-3.0). There was no increased risk of pyelonephritis, placenta previa, or diabetes mellitus in mothers with twins. The twin pregnancies delivered earlier and the infants were smaller, had lower Apgar scores, and were at increased risk for congenital anomalies. Fetal and neonatal mortality rates were significantly increased in the twin infants; the perinatal mortality rates for twin A and twin B were 48.8 and 64.1, respectively, compared with 10.4 per 1000 births for the singleton controls. When the twin infants A and B were of similar weight, they had a similar perinatal mortality (odds ratio 1.0; 95% confidence interval 0.6-1.8). For infants less than 2500 g, twins A and B had lower fetal and neonatal mortality rates than did singletons, but twins heavier than 2500 g were at increased risk of perinatal death.
在1982年至1987年期间的一个地区围产期网络中，101,506名妇女分娩了体重超过500克的婴儿，其中1253例为双胎妊娠（1.2%）。将这后一组与单胎妊娠的5%随机样本（N = 5119）进行统计学比较。结果显示，双胎妊娠的妇女年龄稍大，产次较高，孕期体重增加更多，分娩时体重更重。双胎妊娠并发高血压（比值比2.5；95%置信区间2.1 - 3.1）、胎盘早剥（比值比3.0；95%置信区间1.9 - 4.7）和贫血（比值比2.4；95%置信区间1.9 - 3.0）的情况增多。双胎妊娠母亲患肾盂肾炎、前置胎盘或糖尿病的风险没有增加。双胎妊娠分娩时间更早，婴儿更小，阿氏评分更低，先天性异常风险增加。双胎婴儿的胎儿和新生儿死亡率显著升高；双胎A和双胎B的围产期死亡率分别为48.8和64.1，而单胎对照每1000例出生的围产期死亡率为10.4。当双胎婴儿A和B体重相似时，它们的围产期死亡率相似（比值比1.0；95%置信区间0.6 - 1.8）。对于体重小于2500克的婴儿，双胎A和双胎B的胎儿和新生儿死亡率低于单胎，但体重超过2500克的数据双胎围产期死亡风险增加。
