Li Qiuying, Zhang Hui, Chen Qian, Shi Bijun, Tan Xiaohua, Cui Qiliang
Guangzhou Key Laboratory of Neonatal Intestinal Diseases, Department of Neonatology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangzhou, China.
Transl Pediatr. 2025 Aug 31;14(8):1787-1796. doi: 10.21037/tp-2025-5. Epub 2025 Aug 13.
Advanced maternal age (AMA, ≥35 years) is increasing, linked to delayed childbearing and infertility, with medically assisted reproductive (MAR) technology boosting twin pregnancy rates. Birth weight discordance in twins [BWDT, birth weight discordance (∆BW) >20%] raises neonatal morbidity. Chorionicity matters: monochorionic diamniotic (MCDA) twins face higher risks from placental anastomoses, while dichorionic diamniotic (DCDA) twins have better outcomes. This study explores their association with BWDT. The aim of this study was to characterize the association of chorionicity status in twin pregnancies and BWDT.
A retrospective analysis was conducted on twin infants born between January 2011 and December 2020 at The Third Affiliated Hospital, Guangzhou Medical University, with complete birth data. The relationship between DCDA twins and the occurrence of BWDT was examined via the multivariate logistic regression analysis.
A total of 3,231 pairs of twins were included, including 498 pairs in the MCDA twins group and 2,733 pairs in the DCDA twins group. In the DCDA twins group, the proportion of advanced puerperae (≥35 years old) and first conception was significantly higher than that in the MCDA twins group (P<0.05). An unconditioned logistic regression model was used to control for confounding factors, and the results indicated DCDA twins are at a lower risk for BWDT.
DCDA twins are less likely to have BWDT.
高龄产妇（AMA，≥35岁）数量不断增加，这与生育延迟和不孕有关，医学辅助生殖（MAR）技术提高了双胎妊娠率。双胎出生体重不一致[BWDT，出生体重差异（∆BW）>20%]会增加新生儿发病率。绒毛膜性很重要：单绒毛膜双羊膜囊（MCDA）双胎因胎盘吻合面临更高风险，而双绒毛膜双羊膜囊（DCDA）双胎结局更好。本研究探讨它们与BWDT的关联。本研究的目的是描述双胎妊娠中绒毛膜性状态与BWDT的关联。
对2011年1月至2020年12月在广州医科大学附属第三医院出生、出生数据完整的双胎婴儿进行回顾性分析。通过多因素逻辑回归分析检验DCDA双胎与BWDT发生之间的关系。
共纳入3231对双胎，其中MCDA双胎组498对，DCDA双胎组2733对。DCDA双胎组中高龄产妇（≥35岁）及初产妇比例显著高于MCDA双胎组（P<0.05）。采用非条件逻辑回归模型控制混杂因素，结果表明DCDA双胎发生BWDT的风险较低。
DCDA双胎发生BWDT的可能性较小。
