Chaim W, Fraser D, Mazor M, Leiberman J R
Department of Obstetrics and Gynecology, Soroka Medical Center of Kupat Holim, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Acta Genet Med Gemellol (Roma). 1995;44(1):31-9. doi: 10.1017/s0001566000001872.
This study investigates the influence of hypertensive disorders on twin pregnancies for an unselected, population-based series. Between 1986 and 1991, out of a total of 56,381, 766 (1.3%) were twin deliveries at our institution, the only tertiary care hospital serving a population of about 400,000 inhabitants. The incidence of hypertensive disorders was significantly higher in twin gestations than in singleton pregnancies, at 3437/55,615 (6.2%) vs 85/766 (11.1%) (p < 0.001, OR = 1.8, 95% CI = 1.4-2.3). Hypertensive disorders were significantly higher in twin as compared to singleton pregnancies, regardless of parity, and even after adjusting for maternal age. More instrumental or surgical deliveries were needed when pregnancies were complicated by hypertension, in twin as well as singleton gestations. Despite the association between prematurity and hypertensive disorders, and prematurity and perinatal mortality, no significant difference was found in perinatal mortality between hypertensive and normotensive twin pregnancies. The neonatal death-rate in normotensive and hypertensive twin pregnancies (3.7% and 3.5% respectively) was higher than that of stillbirths (respectively 2.3% and 0%).
本研究针对一个未经筛选的、基于人群的系列，调查了高血压疾病对双胎妊娠的影响。1986年至1991年间，在我们机构分娩的56381766例产妇中，有766例（1.3%）为双胎分娩，我们机构是唯一一家为约40万居民提供三级医疗服务的医院。双胎妊娠中高血压疾病的发生率显著高于单胎妊娠，分别为3437/55615（6.2%）和85/766（11.1%）（p<0.001，OR=1.8，95%CI=1.4-2.3）。无论产次如何，甚至在调整产妇年龄后，双胎妊娠中的高血压疾病发生率均显著高于单胎妊娠。当妊娠合并高血压时，无论是双胎还是单胎妊娠，都需要更多的器械助产或手术分娩。尽管早产与高血压疾病以及早产与围产儿死亡率之间存在关联，但高血压双胎妊娠和血压正常的双胎妊娠在围产儿死亡率方面未发现显著差异。血压正常和高血压双胎妊娠的新生儿死亡率分别为3.7%和3.5%，高于死产率（分别为2.3%和0%）。
