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双胎贫血-红细胞增多序列供体发生新生儿持续性肺动脉高压的风险增加。

Increased Risk of Persistent Pulmonary Hypertension of the Newborn in Twin Anaemia Polycythaemia Sequence Donors.

作者信息

van de Sande Margot J A, Slaghekke Femke, Te Pas Arjan B, Witlox Ruben S G M, Lopriore Enrico, Tollenaar Lisanne S A

机构信息

Division of Fetal Therapy, Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.

Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Fetal Diagn Ther. 2025;52(3):304-313. doi: 10.1159/000542493. Epub 2024 Nov 12.

DOI:10.1159/000542493
PMID:39532069
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12129433/
Abstract

INTRODUCTION

This study aimed to describe the prevalence and risk factors for respiratory complications in monochorionic twins with twin anaemia polycythaemia sequence (TAPS).

METHODS

All neonates diagnosed with postnatal TAPS at our center between 2002 and 2023 were included in this retrospective study. The primary outcome was the prevalence of respiratory complications, including respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), and persistent pulmonary hypertension of the newborn (PPHN). Secondary outcomes included need of respiratory support during admission and a risk factor analysis for adverse respiratory outcome.

RESULTS

In our study of 100 postnatally diagnosed TAPS pregnancies, 32% (62/199) experienced RDS and 13% (25/199) had BPD, with no difference between donors and recipients. PPHN occurred in 7% of cases, more frequently in donors (11%, 11/100) than in recipients (3%, 3/100) (OR = 1.3, 95% CI: 0.2-2.6). Lower gestational age at birth and severe foetal anaemia were found to be significant independent risk factors associated with PPHN in TAPS twins (OR = 0.3, 95% CI: 0.1-0.5), respectively (OR = 1.9, 95% CI: 0.8-3.1).

CONCLUSION

TAPS donor twins have a fourfold increased risk of PPHN due to anaemia compared to recipient twins. Given the life-threatening nature of PPHN, TAPS twins should be born in hospitals equipped to treat it.

摘要

引言

本研究旨在描述患有双胎贫血-红细胞增多序列征（TAPS）的单绒毛膜双胎中呼吸并发症的患病率及危险因素。

方法

本回顾性研究纳入了2002年至2023年间在我们中心诊断为产后TAPS的所有新生儿。主要结局是呼吸并发症的患病率，包括呼吸窘迫综合征（RDS）、支气管肺发育不良（BPD）和新生儿持续性肺动脉高压（PPHN）。次要结局包括入院期间呼吸支持的需求以及不良呼吸结局的危险因素分析。

结果

在我们对100例产后诊断为TAPS的妊娠病例的研究中，32%（62/199）发生了RDS，13%（25/199）发生了BPD，供血儿和受血儿之间无差异。PPHN发生在7%的病例中，供血儿（11%，11/100）比受血儿（3%，3/100）更常见（OR = 1.3，95% CI：0.2 - 2.6）。出生时孕周较小和严重胎儿贫血被发现是与TAPS双胎中PPHN相关的显著独立危险因素（分别为OR = 0.3，95% CI：0.1 - 0.5）（OR = 1.9，95% CI：0.8 - 3.1）。

结论

与受血儿双胎相比，TAPS供血儿双胎因贫血发生PPHN的风险增加四倍。鉴于PPHN的危及生命性质，TAPS双胎应在有能力治疗该病的医院出生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc91/12129433/2a9e60132a9f/fdt-2025-0052-0003-542493_F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc91/12129433/2a9e60132a9f/fdt-2025-0052-0003-542493_F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc91/12129433/2a9e60132a9f/fdt-2025-0052-0003-542493_F01.jpg

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