Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan; Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Clin Chim Acta. 2018 Sep;484:293-297. doi: 10.1016/j.cca.2018.06.015. Epub 2018 Jun 9.
Whether or not the period of fetal lung maturity differs between twin and singleton pregnancies has not been clarified. We examined whether or not fetal lung maturity and fetal lung absorption are achieved earlier in twin fetuses than in singleton fetuses.
We registered 454 singleton pregnancies and 398 twin pregnancies with no congenital abnormalities affecting the respiratory function or neonatal deaths. All patients were delivered by Caesarean section without labor between 24 and 38 gestational weeks. The amniotic fluid samples were analyzed immediately without centrifugation. A multiple logistic regression analysis was performed to explore the relationship between twin pregnancy and neonatal respiratory distress syndrome and transient tachypnea of the newborn (RDS/TTN).
The rate of RDS/TTN in infants was significantly higher and the lamellar body counts (LBCs) significantly lower in singleton pregnancies than that in twin pregnancies (P < .001). According to a multivariate logistic regression analysis, twin pregnancy (odds ratio, 0.34; 95% confidence interval, 0.22-0.55) was a significant preventive factor for neonatal RDS/TTN.
We showed that twin fetuses experience more rapid lung maturation and lung fluid absorption than singleton fetuses, as confirmed by the higher LBC values in twin fetuses.
双胞胎妊娠和单胎妊娠的胎儿肺成熟度是否存在差异尚未明确。我们研究了双胎胎儿的胎儿肺成熟度和胎儿肺吸收是否比单胎胎儿更早。
我们登记了 454 例单胎妊娠和 398 例无先天性异常影响呼吸功能或新生儿死亡的双胎妊娠。所有患者均在 24 至 38 孕周行剖宫产,无临产,且羊水样本未经离心即立即分析。采用多因素逻辑回归分析探讨双胎妊娠与新生儿呼吸窘迫综合征和新生儿暂时性呼吸急促(RDS/TTN)之间的关系。
单胎妊娠的新生儿 RDS/TTN 发生率显著高于双胎妊娠,板层小体计数(LBC)显著低于双胎妊娠(P<0.001)。多因素逻辑回归分析显示,双胎妊娠(比值比,0.34;95%置信区间,0.22-0.55)是新生儿 RDS/TTN 的显著保护因素。
我们发现,双胎胎儿的肺成熟度和肺液吸收速度比单胎胎儿更快,这一点从双胎胎儿较高的 LBC 值中得到了证实。