Gnanendran Lokiny, Bajuk Barbara, Oei Julee, Lui Kei, Abdel-Latif Mohamed E
Department of Medicine, Canberra Hospital, Garran, Australian Capital Territory, Australia.
Neonatal Intensive Care Units' Data Collection, NSW Pregnancy and Newborn Services Network, New South Wales, Australia.
Arch Dis Child Fetal Neonatal Ed. 2015 Mar;100(2):F106-14. doi: 10.1136/archdischild-2013-305677. Epub 2014 Oct 30.
To study the neurodevelopmental outcomes of multiple (twins, triplets, quads) compared with singleton extremely preterm infants <29 weeks gestation.
Population-based retrospective cohort study.
A network of 10 neonatal intensive care units in a geographically defined area of New South Wales and the Australian Capital territory.
1473 infants <29 weeks gestation born between 1 January 1998 and 31 December 2004.
At 2-3 years of corrected age, a neurodevelopmental assessment was conducted using either the Griffiths Mental Developmental Scales or the Bayley Scales of Infant Development II.
Moderate-severe functional disability was defined as developmental delay (Griffiths Mental Developmental Scales General Quotient or Bayley Scales of Infant Development-II Mental Development Index >2 SDs below the mean), moderate cerebral palsy (unable to walk without aids), sensorineural or conductive deafness (requiring amplification) or bilateral blindness (visual acuity <6/60 in the better eye).
Of the 1081 singletons and 392 multiples followed-up, singletons demonstrated higher rates of systemic infections, steroid treatment for chronic lung disease and birth weight <10th percentile. Moderate-severe functional disability did not differ significantly between singletons and multiples (15.8% vs 17.6%, OR 1.14; 95% CI 0.84 to 1.54; p=0.464). Further subgroup analysis of twins, higher-order gestations, 1st-born multiples, 2nd or higher-born multiples, same and unlike gender multiples, did not demonstrate statistically higher rates of functional disability compared with singletons.
Premature infants from multiple gestation pregnancies appear to have comparable neurodevelopmental outcomes to singletons.
研究孕龄小于29周的多胞胎（双胞胎、三胞胎、四胞胎）与单胞胎极早产儿的神经发育结局。
基于人群的回顾性队列研究。
新南威尔士州和澳大利亚首都地区地理界定区域内的10个新生儿重症监护病房网络。
1998年1月1日至2004年12月31日期间出生的1473例孕龄小于29周的婴儿。
在矫正年龄2 - 3岁时，使用格里菲斯心理发育量表或贝利婴儿发育量表第二版进行神经发育评估。
中度至重度功能残疾定义为发育迟缓（格里菲斯心理发育量表总商数或贝利婴儿发育量表第二版心理发育指数低于均值2个标准差以上）、中度脑瘫（无辅助无法行走）、感音神经性或传导性耳聋（需要听力放大）或双眼失明（较好眼视力<6/60）。
在1081名单胞胎和392例多胞胎的随访中，单胞胎全身感染、慢性肺病类固醇治疗及出生体重低于第10百分位数的发生率更高。单胞胎和多胞胎之间中度至重度功能残疾无显著差异（15.8%对17.6%，比值比1.14；95%置信区间0.84至1.54；p = 0.464）。对双胞胎、高阶多胞胎、头胎多胞胎、二胎或更高胎次多胞胎、同性和异性多胞胎进行的进一步亚组分析显示，与单胞胎相比，功能残疾发生率在统计学上无更高水平。
多胎妊娠的早产儿神经发育结局似乎与单胞胎相当。
