The Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat-Gan, Israel.
The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Perinat Med. 2021 Feb 18;49(5):559-565. doi: 10.1515/jpm-2020-0386. Print 2021 Jun 25.
We aim to study the association of maternal age with maternal and neonatal complications in twin pregnancies.
A retrospective cohort study of dichorionic-diamniotic twin pregnancies stratified into three groups according to maternal age ("A" <25, "B" 25-34 and "C" 35-44 years old). Outcome measures included pregnancy, delivery and neonatal complications. A sub-analysis of fertilization pregnancies only was conducted.
Compared with younger women (groups A [n=65] and B [n=783]), older women [group C (n=392)] demonstrated significantly higher rates of gestational diabetes mellitus (B 6.6% vs. A 0%, p =0.027, C 10.2% vs. B 6.6%, p =0.032), were more likely to undergo cesarean deliveries (C 66.6%, B 57.6%, A 52.3%, p =0.007), and were at increased risk of having more than 20% difference in weight between the twins (C 24.5%, B 17.4%, A 16.9%, p =0.013). Other outcomes, including preeclampsia, did not differ between the groups. A sub-analysis of the fertilization only pregnancies was performed. Compared with younger women (groups A [n=18] and B [n=388]), older women (group C [n=230]) underwent more cesarean deliveries (p=0.004), and had more than 20% difference in weight between the twins (p<0.004). Other outcomes, including gestational diabetes mellitus rates and preeclampsia, did not differ between the groups.
Women at advanced maternal age with dichorionic twin pregnancies had significantly higher rates of gestational diabetes mellitus, cesarean deliveries and fetal weight discordancy as compared with younger women. In contrast, the incidence of preeclampsia was not affected by maternal age.
研究母亲年龄与双胎妊娠中母婴并发症的关系。
回顾性队列研究，将双绒毛膜-双羊膜双胎妊娠分为三组，按母亲年龄（“A”<25 岁、“B”25-34 岁和“C”35-44 岁）分层。观察指标包括妊娠、分娩和新生儿并发症。还进行了仅受精妊娠的亚分析。
与年轻女性（A 组[65 例]和 B 组[783 例]）相比，年龄较大的女性（C 组[392 例]）发生妊娠期糖尿病的比例显著更高（B 组为 6.6%，A 组为 0%，p=0.027，C 组为 10.2%，B 组为 6.6%，p=0.032），剖宫产率更高（C 组为 66.6%，B 组为 57.6%，A 组为 52.3%，p=0.007），且双胞胎体重差异超过 20%的风险更高（C 组为 24.5%，B 组为 17.4%，A 组为 16.9%，p=0.013）。其他结局如子痫前期在各组之间无差异。进行了仅受精妊娠的亚分析。与年轻女性（A 组[18 例]和 B 组[388 例]）相比，年龄较大的女性（C 组[230 例]）行剖宫产术的比例更高（p=0.004），双胞胎体重差异超过 20%的比例也更高（p<0.004）。其他结局如妊娠期糖尿病和子痫前期的发生率在各组之间无差异。
与年轻女性相比，高龄产妇（C 组）的双绒毛膜-双羊膜双胎妊娠发生妊娠期糖尿病、剖宫产术和胎儿体重差异的比例明显更高，而子痫前期的发生率不受产妇年龄的影响。
