Department of Gynecology and Obstetrics, AP-HM, Assistance Publique-Hôpitaux de Marseille, Marseille, France.
Department of Gynecology and Obstetrics, AP-HM, Assistance Publique-Hôpitaux de Marseille, Marseille, France; Aix Marseille Univ, Avignon University, CNRS, IRD, IMBE, Marseille, France.
J Gynecol Obstet Hum Reprod. 2022 Mar;51(3):102304. doi: 10.1016/j.jogoh.2021.102304. Epub 2021 Dec 31.
This study compares the neonatal morbidity and mortality of the smallest twins of monochorionic diamniotic (MCDA) pregnancies complicated with selective intrauterine growth restriction (sIUGR) with newborns from singleton pregnancies with intrauterine growth restriction (IUGR).
We conducted a retrospective cohort study of patients managed at the prenatal diagnosis center in a single tertiary care hospital between 2012 and 2019. MCDA twin pregnancies complicated with sIUGR (sIUGR group) were compared with singleton pregnancies with IUGR (IUGR group). The primary outcome was the comparison in neonatal morbidity and mortality between the two groups.
The analysis included 251 patients: 67 in the sIUGR group and 184 in the IUGR group. The two groups were comparable in gestational age and birth weight (p > 0.05). Multivariate analysis controlling for factors that may influence neonatal status showed no significant difference between the two groups in any of the neonatal morbidity criteria or the composite morbidity-mortality endpoint (adjusted OR = 0.946 [95% CI = 0.317-2.827]; p = 0.921).
Despite supposedly different pathophysiological mechanisms, neonates from MCDA pregnancies complicated with sIUGR and those from singleton pregnancies with IUGR appear to have identical neonatal morbidity and mortality .
本研究比较了伴有选择性宫内生长受限（sIUGR）的单绒毛膜双羊膜囊（MCDA）最小双胞胎妊娠与伴有宫内生长受限（IUGR）的单胎妊娠新生儿的发病率和死亡率。
我们对 2012 年至 2019 年在一家三级保健医院产前诊断中心接受治疗的患者进行了回顾性队列研究。将 MCDA 双胎妊娠伴 sIUGR（sIUGR 组）与伴有 IUGR 的单胎妊娠（IUGR 组）进行比较。主要结局是比较两组新生儿发病率和死亡率。
分析共纳入 251 例患者：sIUGR 组 67 例，IUGR 组 184 例。两组的孕龄和出生体重相当（p>0.05）。多变量分析控制了可能影响新生儿状况的因素，结果显示两组在任何新生儿发病率标准或复合发病率-死亡率终点方面均无显著差异（调整 OR=0.946[95%CI=0.317-2.827]；p=0.921）。
尽管可能存在不同的病理生理机制，但伴有 sIUGR 的 MCDA 妊娠新生儿和伴有 IUGR 的单胎妊娠新生儿的新生儿发病率和死亡率似乎相同。
