使用双绒毛膜双胞胎妊娠模型评估新生儿呼吸窘迫综合征与胎儿生长受限的关系。

Association between respiratory distress syndrome of newborns and fetal growth restriction evaluated using a dichorionic twin pregnancy model.

机构信息

Department of Obstetrics and Gynaecology, Sabah Women and Children's Hospital, Kota Kinabalu, Malaysia.

Department of Obstetrics and Gynaecology, Linkou Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Shin Street, Kweishan, Taoyuan ROC 333, Taiwan.

出版信息

J Gynecol Obstet Hum Reprod. 2022 Jun;51(6):102383. doi: 10.1016/j.jogoh.2022.102383. Epub 2022 Apr 18.

DOI:10.1016/j.jogoh.2022.102383

PMID:35447371

Abstract

AIMS

To evaluate the association between respiratory distress syndrome (RDS) and intrauterine fetal growth restriction (IUGR) by using a dichorionic twin model.

METHODS

We retrospectively analyzed twins delivered between September 2012 and December 2018. A dichorionic (DC) twin pregnancy with selective IUGR (sIUGR) was defined as the presence of (i) a birthweight discordance of ≥25% and (ii) a smaller twin with birth weight below the 10th percentile. Pregnancies with major fetal anomalies, delivery at gestational age below 23 weeks, and intrauterine fetal demise were excluded.

RESULTS

We included 53 DC twins with sIUGR. The sIUGR twin had a higher risk of RDS than did his appropriate for gestational age (AGA) cotwin (32.1% vs. 11.3%, p = 0.001); however, the risk of severe RDS did not significantly differ between the twins (17.0% vs 9.4%, p = 0.125). The findings of logistic regression analysis indicated that younger gestational age (weeks) at delivery (odds ratio = 0.48, p < 0.001) and IUGR (odds ratio = 13.87, p = 0.009) were significant risk factors for RDS in newborns in DC twin pregnancies with selective sIUGR.

CONCLUSIONS

IUGR was identified as a risk factor for newborn RDS. However, the association between IUGR and severe newborn RDS was not significant possibly due to the small sample size of this study.

摘要

目的

利用双绒毛膜双胞胎模型评估呼吸窘迫综合征（RDS）与宫内胎儿生长受限（IUGR）之间的关系。

方法

我们回顾性分析了 2012 年 9 月至 2018 年 12 月分娩的双胞胎。双绒毛膜（DC）双胞胎选择性 IUGR（sIUGR）定义为存在（i）出生体重差异≥25%和（ii）较小的双胞胎出生体重低于第 10 百分位。排除了有严重胎儿畸形、分娩孕周<23 周和宫内胎儿死亡的妊娠。

结果

我们纳入了 53 例 DC 双胞胎 sIUGR。sIUGR 双胞胎发生 RDS 的风险高于其相应的适于胎龄儿（AGA）同胞（32.1% vs. 11.3%，p=0.001）；然而，双胞胎之间严重 RDS 的风险无显著差异（17.0% vs. 9.4%，p=0.125）。Logistic 回归分析的结果表明，分娩时的更年轻孕周（周）（比值比=0.48，p<0.001）和 IUGR（比值比=13.87，p=0.009）是 DC 双胞胎选择性 sIUGR 中新生儿 RDS 的显著危险因素。