Lin Nacheng, Shen Ping, Hu Huilian, Song Wenying, Hu Yali, Dai Yimin, Zhou Yi-Hua
Department of Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
Twin Res Hum Genet. 2023 Aug 31:1-6. doi: 10.1017/thg.2023.33.
The aim of this study was to investigate the prevalence of anemia in twin pregnancies and the influence of anemia on maternal and neonatal outcomes. This retrospective study included twin pregnant women who delivered in a tertiary hospital in China from January 2018 to December 2018. Patients were divided by WHO criteria (hemoglobin <11.0 g/dL): the anemic and nonanemic groups. Patients with anemia were further classified as recovered or unrecovered subgroup after oral iron therapy. Maternal and neonatal outcomes in women carrying twins were compared using Student's test and the chi-squared test or the Fisher exact test. Univariable and multivariable logistic regression models were used to determine the association of maternal and neonatal characteristics with anemia. Linear regression analysis was used to estimate mean birth weight and gestational week. The prevalence of anemia was 42.6% (182/427) in twin pregnancies. The anemic group had higher rates of low 1-minute Apgar score (4.4% vs. 1.8%, = .028), perinatal death (1.9% vs. 0.2%, = .012) and neonatal intensive care unit (NICU) admission (27.2% vs. 20.2%, = .017; adjusted , 1.478; 95% CI [1.07, 2.044]). The recovered subgroup had lower NICU admission rate (13.5% vs. 30.3%, = .006; , 0.388; 95% CI [0.186, 0.809]), higher gestational week and birth weight (β, 0.954 week; 95% CI [0.114, 1.794] and β, 171.01 g; 95% CI [9.894, 332.126] respectively). The prevalence of anemia in twin gestation is high. Anemia is associated with adverse neonatal outcomes, and correction of anemia significantly improved the pregnancy outcomes.
本研究旨在调查双胎妊娠中贫血的患病率以及贫血对孕产妇和新生儿结局的影响。这项回顾性研究纳入了2018年1月至2018年12月在中国一家三级医院分娩的双胎孕妇。根据世界卫生组织标准（血红蛋白<11.0 g/dL）将患者分为贫血组和非贫血组。贫血患者在口服铁剂治疗后进一步分为恢复组和未恢复亚组。采用Student检验、卡方检验或Fisher精确检验比较双胎妊娠女性的孕产妇和新生儿结局。使用单变量和多变量逻辑回归模型来确定孕产妇和新生儿特征与贫血的关联。采用线性回归分析来估计平均出生体重和孕周。双胎妊娠中贫血的患病率为42.6%（182/427）。贫血组1分钟Apgar评分低的发生率更高（4.4%对1.8%，P = .028）、围产期死亡率更高（1.9%对0.2%，P = .012）以及新生儿重症监护病房（NICU）入住率更高（27.2%对20.2%，P = .017；校正后比值比，1.478；95%置信区间[1.07，2.044]）。恢复亚组的NICU入住率较低（13.5%对30.3%，P = .006；比值比，0.388；95%置信区间[0.186，0.809]），孕周和出生体重更高（分别为β，0.954周；95%置信区间[0.114，1.794]和β，171.01 g；95%置信区间[9.894，332.126]）。双胎妊娠中贫血的患病率很高。贫血与不良新生儿结局相关，纠正贫血可显著改善妊娠结局。
