Chen S J, Vohr B R, Oh W
Neonatal Follow-up Clinic, Women and Infants' Hospital, Brown University School of Medicine, Providence, Rhode Island 02905.
J Pediatr. 1993 Jul;123(1):132-6. doi: 10.1016/s0022-3476(05)81556-2.
We hypothesized that gender and intrauterine growth retardation (IUGR) have greater effects than birth order on mortality and morbidity rates of very low birth weight (< 1501 gm) twins. Neonatal data were collected on 44 pairs of twins born alive between January 1984 and December 1987. Birth weight was 1018 +/- 289 gm and gestational age was 28.1 +/- 2.5 weeks. The male/female ratio was 46:42; 24 infants had IUGR, and 64 were appropriate in size for gestational age. Of the 88 infants, 61 (69%) survived. Birth order had no effect on outcome. Female twin pairs had a longer gestation than either male twin pairs or twins with discordant sex (29.2 +/- 2.5 weeks vs 27.4 +/- 2.0 weeks and 27 +/- 3 weeks, respectively; p < 0.002). They also had a lower mortality rate (14% vs 47% and 25%; p < 0.001) and a lower incidence of bronchopulmonary dysplasia (22% vs 57% and 50%; p < 0.02). Infants with IUGR had an increased mortality rate (50% vs 23%; p < 0.02) and an increased sepsis rate (61% vs 25%; p < 0.02) compared with infants with appropriate size for gestational age who were matched for gestational age. Multiple logistic regression analysis to assess the independent effects of gestational age, gender, and IUGR on mortality rate, bronchopulmonary dysplasia, and intraventricular hemorrhage revealed that gestational age was the most significant contributor to all three outcome variables; IUGR contributed to an increased mortality rate, and male gender contributed to the occurrence of bronchopulmonary dysplasia.
我们假设，对于极低出生体重（<1501克）的双胞胎，性别和宫内生长迟缓（IUGR）对死亡率和发病率的影响比出生顺序更大。收集了1984年1月至1987年12月期间出生存活的44对双胞胎的新生儿数据。出生体重为1018±289克，胎龄为28.1±2.5周。男女比例为46:42；24名婴儿患有IUGR，64名婴儿的大小与胎龄相符。在这88名婴儿中，61名（69%）存活。出生顺序对结局无影响。女性双胞胎对的妊娠期比男性双胞胎对或性别不一致的双胞胎更长（分别为29.2±2.5周、27.4±2.0周和27±3周；p<0.002）。她们的死亡率也较低（分别为14%、47%和25%；p<0.001），支气管肺发育不良的发生率也较低（分别为22%、57%和50%；p<0.02）。与胎龄匹配、大小与胎龄相符的婴儿相比，患有IUGR的婴儿死亡率增加（分别为50%和23%；p<0.02），败血症发生率增加（分别为61%和25%；p<0.02）。多因素logistic回归分析评估胎龄、性别和IUGR对死亡率、支气管肺发育不良和脑室内出血的独立影响，结果显示胎龄是所有三个结局变量的最重要因素；IUGR导致死亡率增加，男性导致支气管肺发育不良的发生。
