多胎妊娠是否会影响吸烟导致的出生体重不足？
Does multiple gestation impact birthweight deficit from smoking?
机构信息
Department of Pediatrics, Children's Mercy Hospitals and Clinics/University of Missouri Kansas City School of Medicine, Kansas City, MO, USA.
University of Missouri Kansas City School of Pharmacy, Kansas City, MO, USA.
出版信息
J Perinatol. 2014 Feb;34(2):112-5. doi: 10.1038/jp.2013.148. Epub 2013 Dec 5.
OBJECTIVE
To test the hypothesis that the combined birthweight deficit from smoking in twin gestation is significantly greater than previously described for singletons.
STUDY DESIGN
Retrospective cohort study of White/Black live-born twins, 32 to 40 weeks of gestation, 1990 to 2005, Kansas City, MO. Data were analyzed by t-test, χ(2), linear and linear regression analyses.
RESULT
The cohort comprised 1190 twin pairs, 58% Whites and 55% ≥37 weeks. Smoking rate was 14.5% and similar by race (14.2% White vs 14.8%, P=0.772). The aggregate birthweight of twins of nonsmokers was greater, 5116 g ± 25 g vs 4870 g ± 59 g, P<0.001 (mean±s.d.) and the difference was 264 g (95% confidence interval, 156 to 372 g) after adjusting for other variables in linear regression analyses.
CONCLUSION
Smoking-associated growth restriction in twins is quantitatively similar to that of singletons. This finding is suggestive of dissipation or a ceiling effect to the growth-restricting effect of cigarette smoking.
目的
检验这样一个假设，即在双胞胎妊娠中，吸烟导致的出生体重综合不足比之前描述的单胎妊娠更为显著。
研究设计
这是一项回顾性队列研究，研究对象为白种人/黑种人在孕 32 至 40 周时、于 1990 至 2005 年间在堪萨斯城出生的活产双胞胎。数据分析采用 t 检验、卡方检验、线性和线性回归分析。
结果
该队列包括 1190 对双胞胎，其中 58%为白人，55%的胎儿妊娠周数大于等于 37 周。吸烟率为 14.5%，且在白人和非白人中相似（14.2%比 14.8%，P=0.772）。不吸烟者的双胞胎总体出生体重更大，为 5116 g ± 25 g 比 4870 g ± 59 g，P<0.001（均值±标准差），且这一差异在进行线性回归分析时调整其他变量后为 264 g（95%置信区间为 156 至 372 g）。
结论
吸烟导致的双胞胎生长受限在数量上与单胎妊娠相似。这一发现提示香烟对生长的抑制作用可能已经耗尽或达到上限。
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