孕晚期出生的单纯性单绒毛膜双羊膜囊双胎的发育和行为结局
Developmental and behavioral outcomes of uncomplicated monochorionic diamniotic twins born in the third trimester.
作者信息
Sierakowski Amy, Eapen Valsamma, Črnčec Rudi, Smoleniec John
机构信息
University of New South Wales.
School of Psychiatry, University of New South Wales.
出版信息
Neuropsychiatr Dis Treat. 2017 May 19;13:1373-1384. doi: 10.2147/NDT.S122739. eCollection 2017.
BACKGROUND
Relatively little is known about the neurodevelopmental and behavioral outcomes of monochorionic diamniotic (MCDA) twin pregnancies where there are no antenatal complications peculiar to monochorionicity or prematurity.
METHODS
Twenty-two MCDA twins (44 children) with an average age of 4.3 years, and with no antenatal complications detected by 28 weeks of gestation, were recruited from a feto-maternal unit database. Parents completed a battery of neurodevelopmental and behavioral assessment questionnaires.
RESULTS
Eighteen children (41%) were identified as having developmental or behavioral concerns, predominantly of mild severity, which in turn were associated with a lower birth weight of medium effect size (Cohen's =0.59).
CONCLUSION
MCDA twins delivered in the third trimester with no antenatal monochorionic complications in the first two trimesters appear to be at risk for subtle neurodevelopmental difficulties, associated with a lower birth weight. Ongoing developmental surveillance of these children during preschool-age is indicated for early identification and intervention.
背景
对于双绒毛膜双羊膜囊（MCDA）双胎妊娠且无单绒毛膜性或早产特有的产前并发症的神经发育和行为结局，人们了解相对较少。
方法
从一个胎儿 - 母体单位数据库中招募了22对MCDA双胞胎（44名儿童），平均年龄为4.3岁，妊娠28周时未检测到产前并发症。父母完成了一系列神经发育和行为评估问卷。
结果
18名儿童（41%）被确定存在发育或行为问题，主要为轻度严重程度，这又与中等效应量的较低出生体重相关（科恩氏d = 0.59）。
结论
孕晚期分娩且前两孕期无产前单绒毛膜并发症的MCDA双胞胎似乎存在轻微神经发育困难的风险，与较低出生体重有关。建议在学龄前对这些儿童进行持续的发育监测，以便早期识别和干预。
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