Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
Hunan University of Medicine, Huaihua, Hunan, China.
PLoS One. 2019 Jan 30;14(1):e0211683. doi: 10.1371/journal.pone.0211683. eCollection 2019.
Twins with discordant growth have increased risks of perinatal mortality and morbidity. Previous studies have identified a number of risk factors for inter-twin birth weight discordance, yet no study has examined the effect of maternal hepatitis C infection.
We used the twin birth records extracted from the 2011 to 2015 United States birth records created by the Centers for Disease Control and Prevention. The outcome variable of this study was inter-twin birth weight discordance, defined as [(birth weight of larger twin-birth weight of smaller twin) / birth weight of larger twin]. The independent association of hepatitis C infection with birth weight discordance was examined using the gamma regression or log binomial regression, adjusted by potential confounders.
Of the 270,256 twin pairs included in the final analysis, 850 (0.31%) had positive hepatitis C. Compared to mothers without hepatitis C, mothers with hepatitis C positive tended to have higher risk of birth weight discordance, but with no statistical significance. After adjustment for potential confounding factors, hepatitis C positive became a significant risk factor for birth weight discordance >25% (relative risk 1.14, 95% confidence interval 1.02-1.29). Sensitivity analyses (by treating birth weight discordance as a continuous outcome or dichotomizing into by different cutoffs) yielded similar results, with relative risks ranging from 1.07 to 1.12 (all P<0.05).
Maternal hepatitis C positive is associated with inter-twin birth weight discordance, an important adverse infant outcome in twin pregnancies, although the effect size is small.
生长不一致的双胞胎具有增加围产期死亡率和发病率的风险。先前的研究已经确定了许多双胎出生体重不一致的风险因素，但没有研究检查过母体丙型肝炎感染的影响。
我们使用了美国疾病控制与预防中心创建的 2011 年至 2015 年美国出生记录中提取的双胞胎出生记录。本研究的结果变量是双胎出生体重不一致，定义为[(较大双胞胎的出生体重-较小双胞胎的出生体重)/较大双胞胎的出生体重]。使用伽马回归或对数二项式回归检查丙型肝炎感染与出生体重不一致的独立关联，并通过潜在混杂因素进行调整。
在最终分析的 270256 对双胞胎中，有 850 对（0.31%）丙型肝炎阳性。与没有丙型肝炎的母亲相比，丙型肝炎阳性的母亲出生体重不一致的风险较高，但无统计学意义。调整潜在混杂因素后，丙型肝炎阳性成为出生体重不一致>25%的显著危险因素（相对风险 1.14，95%置信区间 1.02-1.29）。敏感性分析（将出生体重不一致视为连续结果或分为不同的截断值）得出了类似的结果，相对风险范围为 1.07 至 1.12（均 P<0.05）。
母体丙型肝炎阳性与双胎出生体重不一致有关，这是双胎妊娠中一个重要的不良婴儿结局，尽管影响大小较小。
