择期剖宫产术后双胎与单胎新生儿呼吸系统并发症比较。

Neonatal respiratory morbidity in twins versus singletons after elective prelabor caesarean section.

机构信息

Department of Obstetrics and Gynaecology, S. Orsola-Malpighi University Hospital, Bologna, Italy.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2013 Feb;166(2):156-60. doi: 10.1016/j.ejogrb.2012.10.020. Epub 2012 Dec 6.

DOI:10.1016/j.ejogrb.2012.10.020

PMID:23219293

Abstract

OBJECTIVE

To compare the rate of neonatal respiratory morbidity in singletons versus twins delivered by pre-labour caesarean section.

STUDY DESIGN

Uncomplicated pregnancies delivered by prelabor caesarean section at 34+0 to 37+6 weeks' gestation were retrospectively selected. For both singletons and twins caesarean delivery was undertaken electively only after amniocentesis and if the lecithin/sphingomyelin ratio was ≥2. Neonatal respiratory morbidity was compared in twins versus singletons.

RESULTS

241 singletons and 100 twin neonates were included. Overall neonatal respiratory morbidity was comparable between the two groups (25/241 (11.7%) versus 7/100 (7%), p=.331). Between 34+0 and 36+6 weeks, however, the risk was higher among singleton than twins (15/46 (32.6%) versus 6/72 (8.3%), p<.001). At multiple regression, dichorionicity, gestational age at delivery ≥37 weeks and female sex independently decreased the risk of neonatal respiratory morbidity.

CONCLUSION

The risk of neonatal respiratory morbidity after elective caesarean section seems lower among twins, especially prior to 37+0 weeks.

摘要

目的

比较经产前剖宫产分娩的单胎与双胎新生儿呼吸系统发病率。

研究设计

本研究回顾性选择了无并发症的单胎和双胎孕妇，在妊娠 34+0 至 37+6 周行择期剖宫产。对于单胎和双胎孕妇，仅在羊膜穿刺术后，如果卵磷脂/鞘磷脂比值≥2 时才进行选择性剖宫产。比较了双胎与单胎新生儿的呼吸系统发病率。

结果

共纳入 241 例单胎和 100 例双胎新生儿。两组新生儿呼吸系统发病率总体无差异（25/241（11.7%）与 7/100（7%），p=.331）。然而，在 34+0 至 36+6 周时，单胎的风险高于双胎（15/46（32.6%）与 6/72（8.3%），p<.001）。在多因素回归分析中，双绒毛膜性、分娩时胎龄≥37 周和女性性别独立降低了新生儿呼吸系统发病率的风险。