Petterson B, Nelson K B, Watson L, Stanley F
Western Australian Research Institute for Child Health, Princess Margaret Hospital for Children, Perth.
BMJ. 1993 Nov 13;307(6914):1239-43. doi: 10.1136/bmj.307.6914.1239.
To examine the rate of cerebral palsy in twins and triplets in births from 1980 to 1989 in Western Australia and to identify factors associated with increase in risk.
Pluralities for all births in Western Australia were identified through the standardised midwives' notification system, and cases of cerebral palsy were identified from the Western Australian cerebral palsy register.
Multiple births, cerebral palsy, excluding postneonatal cause.
The prevalence of cerebral palsy in triplets, of 28 per 1000 survivors to 1 year (95% confidence interval 11 to 63) exceeded that in twins (7.3; 5.2 to 10) and singletons (1.6; 1.4 to 1.8). Although twins and triples were more likely than singletons to be low in birth weight, their risks of cerebral palsy if low in birth weight were similar. In contrast, in normal birthweight categories twins had a higher rate of cerebral palsy (4.2; 2.2 to 7.7) than singletons (1.1; 1.0 to 1.3). The prevalence of cerebral palsy was similar in twins of unlike sex pairs, all of whom are dizygotic, and in like sex pairs. A twin pair in which one member died in utero was at higher risk of cerebral palsy: 96 per 1000 twin pairs (36 to 218) compared with 12 (8.2 to 17) for twin pregnancies in which both survived. There was a similar but non-significant trend for death of one triplet to be associated with increased risk of cerebral palsy in the survivors of the set.
Triplet pregnancies produced a child with cerebral palsy 47 times more often than singleton pregnancies did and twin pregnancies eight times more often. Eighty six per cent of cerebral palsy in multiple births was in twins. As multiple births are increasing mainly because of personal and medical decisions the increased risk of cerebral palsy in multiple births is of concern.
研究1980年至1989年西澳大利亚州出生的双胞胎和三胞胎的脑瘫发病率，并确定与之相关的风险增加因素。
通过标准化助产士通报系统确定西澳大利亚州所有出生的多胞胎情况，并从西澳大利亚州脑瘫登记册中识别脑瘫病例。
多胎分娩、脑瘫（不包括新生儿期后的病因）。
三胞胎中脑瘫患病率为每1000名1岁存活者中有28例（95%置信区间为11至63），高于双胞胎（7.3；5.2至10）和单胞胎（1.6；1.4至1.8）。尽管双胞胎和三胞胎比单胞胎更易出现低体重出生，但如果出生体重低，他们患脑瘫的风险相似。相比之下，在正常出生体重类别中，双胞胎患脑瘫的比例（4.2；2.2至7.7）高于单胞胎（1.1；1.0至1.3）。在性别不同的双胞胎（均为异卵双胞胎）和性别相同的双胞胎中，脑瘫患病率相似。一对双胞胎中若有一个在子宫内死亡，则另一个患脑瘫的风险更高：每1000对双胞胎中有96例（36至218），而两个都存活的双胞胎妊娠中这一比例为12例（8.2至17）。在一组三胞胎中，若有一个死亡，其存活者患脑瘫风险增加，也有类似但不显著的趋势。
三胞胎妊娠生出脑瘫患儿的几率比单胞胎妊娠高47倍，比双胞胎妊娠高8倍。多胎分娩中86%的脑瘫患儿是双胞胎。由于多胎分娩增加主要是个人和医疗决策所致，多胎分娩中脑瘫风险增加令人担忧。
