McCulloch K
Department of Pediatrics, University of Illinois Medical Center, Chicago.
Clin Perinatol. 1988 Mar;15(1):141-58.
Twins have higher rates of perinatal mortality, prematurity and its complications, low birth weight, intrauterine growth retardation, congenital anomalies, and long-term developmental morbidity. Monozygotic twins have lower birth weights and higher rates of congenital anomalies than dizygotic twins, which suggests that the etiology of these problems may be related to the monozygotic twinning process. Monochorionic twins have higher rates of perinatal mortality, intrapair birth weight discrepancies, and intrauterine growth retardation than dichorionic twins, which suggests that these complications may be related to placental vascular anastomoses. Monochorial vascular communications also can be responsible for twin transfusion syndrome, disseminated intravascular coagulation at birth and disruptive structural defects. Followup studies indicate that twins remain at a disadvantage for subsequent physical growth and intellectual achievement. The management of twins is challenging and fascinating because of the wide range of perinatal, neonatal, developmental, and parenting problems that can occur.
双胞胎的围产期死亡率、早产及其并发症、低出生体重、宫内生长迟缓、先天性异常以及长期发育疾病的发生率较高。同卵双胞胎比异卵双胞胎出生体重更低，先天性异常发生率更高，这表明这些问题的病因可能与同卵双胎形成过程有关。单绒毛膜双胞胎比双绒毛膜双胞胎的围产期死亡率、双胞胎之间出生体重差异以及宫内生长迟缓的发生率更高，这表明这些并发症可能与胎盘血管吻合有关。单绒毛膜血管连通也可能导致双胎输血综合征、出生时弥散性血管内凝血以及破坏性结构缺陷。随访研究表明，双胞胎在随后的身体生长和智力成就方面仍处于劣势。由于可能出现的围产期、新生儿期、发育和养育问题范围广泛，双胞胎的管理具有挑战性且引人入胜。
