Telethon Kids Institute, Nedlands, Western Australia, Australia
School of Population and Global Health, The University of Western Australia Faculty of Health and Medical Sciences, Perth, Western Australia, Australia.
BMJ Open. 2020 Oct 16;10(10):e038846. doi: 10.1136/bmjopen-2020-038846.
To investigate the prevalence of, and associations between, prenatal and perinatal risk factors and developmental vulnerability in twins at age 5.
Retrospective cohort study using bivariate and multivariable logistic regression.
Western Australia (WA), 2002-2015.
828 twin pairs born in WA with an Australian Early Development Census (AEDC) record from 2009, 2012 or 2015.
The AEDC is a national measure of child development across five domains. Children with scores <10th percentile were classified as developmentally vulnerable on, one or more domains (DV1), or two or more domains (DV2).
In this population, 26.0% twins were classified as DV1 and 13.5% as DV2. In the multivariable model, risk factors for DV1 were maternal age <25 years (adjusted OR (aOR): 7.06, 95% CI: 2.29 to 21.76), child speaking a language other than English at home (aOR: 6.45, 95% CI: 2.17 to 19.17), male child (aOR: 5.08, 95% CI: 2.89 to 8.92), age younger than the reference category for the study sample (≥5 years 1 month to <5 years 10 months) at time of AEDC completion (aOR: 3.34, 95% CI: 1.55 to 7.22) and having a proportion of optimal birth weight (POBW) <15th percentile of the study sample (aOR: 2.06, 95% CI 1.07 to 3.98). Risk factors for DV2 were male child (aOR: 7.87, 95% CI: 3.45 to 17.97), maternal age <25 (aOR: 5.60, 95% CI: 1.30 to 24.10), age younger than the reference category (aOR: 5.36, 95% CI: 1.94 to 14.82), child speaking a language other than English at home (aOR: 4.65, 95% CI: 1.14 to 19.03), mother's marital status as not married at the time of twins' birth (aOR: 4.59, 95% CI: 1.13 to 18.55), maternal occupation status in the lowest quintile (aOR: 3.30, 95% CI: 1.11 to 9.81) and a POBW <15th percentile (aOR: 3.11, 95% CI: 1.26 to 7.64).
Both biological and sociodemographic risk factors are associated with developmental vulnerability in twins at 5 years of age.
调查产前和围产期风险因素与 5 岁双胞胎发育脆弱的相关性。
使用双变量和多变量逻辑回归的回顾性队列研究。
西澳大利亚州（WA），2002-2015 年。
2009 年、2012 年或 2015 年在 WA 出生且具有澳大利亚早期发展普查（AEDC）记录的 828 对双胞胎。
AEDC 是一项针对五个领域儿童发展的全国性衡量标准。在一个或多个领域（DV1）或两个或更多领域（DV2）得分低于第 10 百分位数的儿童被归类为发育脆弱。
在该人群中，26.0%的双胞胎被归类为 DV1，13.5%的双胞胎被归类为 DV2。在多变量模型中，DV1 的风险因素为母亲年龄<25 岁（调整后的比值比（aOR）：7.06，95%CI：2.29 至 21.76）、儿童在家中说英语以外的语言（aOR：6.45，95%CI：2.17 至 19.17）、男性儿童（aOR：5.08，95%CI：2.89 至 8.92）、在 AEDC 完成时年龄小于研究样本参考类别（≥5 岁 1 个月至<5 岁 10 个月）（aOR：3.34，95%CI：1.55 至 7.22）和具有低于研究样本 15%的最佳出生体重比例（POBW）（aOR：2.06，95%CI 1.07 至 3.98）。DV2 的风险因素为男性儿童（aOR：7.87，95%CI：3.45 至 17.97）、母亲年龄<25 岁（aOR：5.60，95%CI：1.30 至 24.10）、年龄小于参考类别（aOR：5.36，95%CI：1.94 至 14.82）、儿童在家中说英语以外的语言（aOR：4.65，95%CI：1.14 至 19.03）、母亲在双胞胎出生时的婚姻状况未婚（aOR：4.59，95%CI：1.13 至 18.55）、母亲职业状况处于最低五分位数（aOR：3.30，95%CI：1.11 至 9.81）和 POBW<15%（aOR：3.11，95%CI：1.26 至 7.64）。
生物学和社会人口学风险因素均与 5 岁双胞胎的发育脆弱有关。
