Medearis A L, Jonas H S, Stockbauer J W, Domke H R
Am J Obstet Gynecol. 1979 Jun 15;134(4):413-21. doi: 10.1016/s0002-9378(16)33083-6.
Analysis of computer-stored State of Missouri birth and death records over a 5 year period revealed 3,594 twin pregnancies (1.02% of all pregnancies), which accounted for 10.1% of the perinatal deaths. The mean birth weight according to weeks of gestation was computed for the pregnancies with no complications noted prior to labor and the perinatal mortality rate was determined. Complications of pregnancy were evaluated. Low birth weight appears to be the major factor in the elevated perinatal death rate in twin pregnancy, with a significant elevation of the perinatal death rate noted with labor prior to 36 weeks, any episode of hemorrhage, or premature rupture of membranes. A more liberal use of cesarean section currently shows no effect in altering the perinatal mortality rate. Programs are suggested to increase early detection and appropriate consultation and referral of multiple pregnancies in a statewide comprehensive effort to decrease the perinatal mortality rate in twin pregnancy.
对密苏里州计算机存储的5年出生和死亡记录进行分析后发现，有3594例双胎妊娠（占所有妊娠的1.02%），占围产期死亡的10.1%。计算了分娩前未发现并发症的妊娠按孕周的平均出生体重，并确定了围产期死亡率。对妊娠并发症进行了评估。低出生体重似乎是双胎妊娠围产期死亡率升高的主要因素，在36周前分娩、任何出血事件或胎膜早破时，围产期死亡率显著升高。目前更广泛地使用剖宫产对改变围产期死亡率没有效果。建议开展相关项目，在全州范围内进行全面努力，加强对多胎妊娠的早期检测以及适当的咨询和转诊，以降低双胎妊娠的围产期死亡率。
