Department of Obstetrics and Gynaecology, S. Orsola-Malpighi University Hospital, Bologna, Italy.
Eur J Obstet Gynecol Reprod Biol. 2013 Feb;166(2):156-60. doi: 10.1016/j.ejogrb.2012.10.020. Epub 2012 Dec 6.
To compare the rate of neonatal respiratory morbidity in singletons versus twins delivered by pre-labour caesarean section.
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.
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.
The risk of neonatal respiratory morbidity after elective caesarean section seems lower among twins, especially prior to 37+0 weeks.
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。
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。
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。
与单胎相比，择期剖宫产分娩的双胎新生儿呼吸系统发病率似乎较低，尤其是在 37+0 周之前。
