Kapidaki M, Roupa Z, Sparos L, Tzonou A, Olsen J, Trichopoulos D
Department of Hygiene and Epidemiology, University of Athens Medical School, Greece.
Epidemiology. 1995 May;6(3):294-8. doi: 10.1097/00001648-199505000-00018.
We conducted a case-control study of factors that may be related to the prevalence of multiple births with at least one liveborn. Over a period of 15 months during 1991-1992 in Athens, Greece, we identified 380 women who had a multiple birth that was delivered in one of the six larger maternity hospitals in the area. We selected as controls 380 livebirth singleton pregnancies delivered at the same hospitals immediately following a multiple pregnancy. All mothers were interviewed in the maternity wards or at home, and zygosity was ascertained through the similarity method. The odds ratio for ovulation-inducing drugs was not elevated for monozygotic twins, but it was 9-fold for dizygotic twins and 90-fold for triplets or quadruplets. We excluded drug-induced pregnancies, twins of indeterminable zygosity, and all triplets from further analyses. We found no remarkable association between any of the study variables and the occurrence of monozygotic twins, with the exception of an increasing trend with age. For dizygotic twins, we found weak associations in the expected directions with maternal age (positive) and height (positive) as well as with parity and number of induced abortions (positive). A history of oral contraceptive use was inversely, but weakly, associated with dizygotic twinning. Each cup of coffee per day was associated with an increment in the odds ratio of 1.23-fold. (95% confidence interval = 1.05-1.43). Restriction of the analysis to dizygotic twins of different gender increased the point estimate of the odds ratio to 1.31 for each cup of coffee consumed daily.(ABSTRACT TRUNCATED AT 250 WORDS)
我们开展了一项病例对照研究,探究可能与至少有一个活产儿的多胎妊娠患病率相关的因素。在1991年至1992年期间的15个月里,我们在希腊雅典,确定了380名在该地区六家较大的妇产医院之一分娩多胎的女性。我们选取了在多胎妊娠之后紧接着在同一家医院分娩的380例单胎活产妊娠作为对照。所有母亲均在产科病房或家中接受访谈,并通过相似性方法确定合子性。对于单卵双胞胎,促排卵药物的比值比未升高,但对于双卵双胞胎为9倍,对于三胞胎或四胞胎为90倍。我们在进一步分析中排除了药物诱导的妊娠、合子性无法确定的双胞胎以及所有三胞胎。我们发现,除了随着年龄增加的趋势外,任何研究变量与单卵双胞胎的发生之间均无显著关联。对于双卵双胞胎,我们发现其与母亲年龄(正相关)、身高(正相关)以及产次和人工流产次数(正相关)在预期方向上存在弱关联。口服避孕药史与双卵双胎呈负相关,但较弱。每天喝一杯咖啡会使比值比增加1.23倍(95%置信区间 = 1.05 - 1.43)。将分析限制在不同性别的双卵双胞胎中,每天喝一杯咖啡的比值比点估计值增加到1.31。(摘要截短至250字)