Zhu Caixia, Wang Malie, Niu Gang, Yang Juan, Wang Zilian
Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Taiwan J Obstet Gynecol. 2018 Feb;57(1):64-67. doi: 10.1016/j.tjog.2017.12.010.
To evaluate obstetric outcomes in twin pregnancies of advanced maternal age (≥35 years).
A retrospective study involved 470 twin pregnancies in a single center from Sep. 1, 2012 to Mar. 31, 2015. Clinical characteristics and obstetric outcomes were recorded and compared among twin pregnancies who were classified as follows: age 20-29, 30-34, 35-39 and ≥40 years.
The incidence of gestational diabetes (age 20-29 years 15.8%; 30-34 years 24.3%; 35-39 years 30.4%; ≥40 years 57.1%; p = 0.004) and premature delivery (20-29 years 58.6%; 30-34 years 69.1%; 35-39 years 72.2%; ≥40 years 85.7%; p = 0.001) significantly increased with increasing age whereas spontaneous abortion (20-29 years 27.6%; 30-34 years 11.6%; 35-39 years 11.4%; ≥40 years 0.0%; p = 0.021) decreased in twin pregnancies of advanced maternal age. In addition, the rate of postpartum hemorrhage increased almost continuously by age and advanced maternal age was described as a risk factor for postpartum hemorrhage (age 35-39, adjusted OR 3.377; 95% confidence interval 1729-6.598; p < 0.001; age ≥ 40, adjusted OR 10.520; 95% CI 1.147-96.492; p = 0.037). However, there was no significant difference between advanced maternal age and adverse neonatal outcomes.
In twin pregnancies, advanced maternal age experienced significant higher risk of postpartum hemorrhage, gestational diabetes and premature delivery. Neither adverse neonatal outcomes nor stillbirth was significantly associated with maternal age.
评估高龄孕产妇（≥35岁）双胎妊娠的产科结局。
一项回顾性研究纳入了2012年9月1日至2015年3月31日期间在单一中心的470例双胎妊娠。记录并比较了以下分类的双胎妊娠的临床特征和产科结局：年龄20 - 29岁、30 - 34岁、35 - 39岁和≥40岁。
妊娠期糖尿病的发生率（20 - 29岁为15.8%；30 - 34岁为24.3%；35 - 39岁为30.4%；≥40岁为57.1%；p = 0.004）和早产率（20 - 29岁为58.6%；30 - 34岁为69.1%；35 - 39岁为72.2%；≥40岁为85.7%；p = 0.001）随着年龄增长显著增加，而高龄孕产妇双胎妊娠的自然流产率（20 - 29岁为27.6%；30 - 34岁为11.6%；35 - 39岁为11.4%；≥40岁为0.0%；p = 0.021）下降。此外，产后出血率几乎随年龄持续上升，高龄孕产妇被描述为产后出血的一个危险因素（35 - 39岁，校正OR 3.377；95%置信区间1.729 - 6.598；p < 0.001；≥40岁，校正OR 10.520；95% CI 1.147 - 96.492；p = 0.037）。然而，高龄孕产妇与不良新生儿结局之间无显著差异。
在双胎妊娠中，高龄孕产妇发生产后出血、妊娠期糖尿病和早产的风险显著更高。不良新生儿结局和死产均与孕产妇年龄无显著关联。
