Department of Epidemiology and Quantitative Methods in Health, Sérgio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
Medical School of Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
PLoS One. 2021 Jan 11;16(1):e0245152. doi: 10.1371/journal.pone.0245152. eCollection 2021.
Twin pregnancies account for 0.5-2.0% of all gestations worldwide. They have a negative impact on perinatal health indicators, mainly owing to the increased risk for preterm birth. However, population-based data from low/middle income countries are limited. The current paper aims to understand the health risks of twins, compared to singletons, amongst late preterms and early terms.
Data is from "Birth in Brazil", a national inquiry into childbirth care conducted in 2011/2012 in 266 maternity hospitals. We included women with a live birth or a stillborn, and excluded births of triplets or more, totalling 23,746 singletons and 554 twins. We used multiple logistic regressions and adjusted for potential confounders.
Twins accounted for 1.2% of gestations and 2.3% of newborns. They had higher prevalence of low birth weight and intrauterine growth restriction, when compared to singletons, in all gestational age groups, except in the very premature ones (<34 weeks). Amongst late preterm's, twins had higher odds of jaundice (OR 2.7, 95% CI 1.8-4.2) and antibiotic use (OR 1.8, 95% CI 1.1-3.2). Amongst early-terms, twins had higher odds of oxygen therapy (OR 2.7, 95% CI 1.3-5.9), admission to neonatal intensive care unit (OR 3.1, 95% CI 1.5-6.5), transient tachypnoea (OR 3.7, 95% CI 1.5-9.2), jaundice (OR 2.8, 95% CI 1.3-5.9) and antibiotic use (OR 2.2, 95% CI 1.14.9). In relation to birth order, the second-born infant had an elevated likelihood of jaundice, antibiotic use and oxygen therapy, than the first-born infant.
Although strongly mediated by gestational age, an independent risk remains for twins for most neonatal morbidities, when compared to singletons. These disadvantages seem to be more prominent in early-term newborns than in the late preterm ones.
双胞胎妊娠占全球妊娠的 0.5-2.0%。它们对围产期健康指标有负面影响，主要是由于早产风险增加。然而，来自中低收入国家的基于人群的数据有限。目前的论文旨在了解与单胎相比，晚期早产儿和早期早产儿中双胞胎的健康风险。
数据来自“巴西出生”，这是一项于 2011/2012 年在 266 家产科医院进行的全国生育护理调查。我们纳入了活产儿或死产儿，排除了三胞胎或更多的分娩，共有 23746 名单胎和 554 对双胞胎。我们使用多因素逻辑回归并调整了潜在的混杂因素。
双胞胎占妊娠的 1.2%，占新生儿的 2.3%。除了非常早产（<34 周）外，在所有孕龄组中，与单胎相比，双胞胎的低出生体重和宫内生长受限发生率更高。在晚期早产儿中，双胞胎黄疸（OR 2.7，95%CI 1.8-4.2）和抗生素使用（OR 1.8，95%CI 1.1-3.2）的可能性更高。在早期早产儿中，双胞胎接受氧气治疗（OR 2.7，95%CI 1.3-5.9）、入住新生儿重症监护病房（OR 3.1，95%CI 1.5-6.5）、短暂性呼吸急促（OR 3.7，95%CI 1.5-9.2）、黄疸（OR 2.8，95%CI 1.3-5.9）和抗生素使用（OR 2.2，95%CI 1.14.9）的可能性更高。关于出生顺序，与第一胎相比，第二胎婴儿黄疸、抗生素使用和氧气治疗的可能性更高。
尽管主要受胎龄影响，但与单胎相比，双胞胎在大多数新生儿疾病方面仍存在独立风险。与晚期早产儿相比，这些劣势在早期早产儿中更为突出。
