Yokoyama Y, Shimizu T, Hayakawa K
Department of Public Health, Kinki University School of Medicine, Osaka, Japan.
Int J Epidemiol. 1995 Oct;24(5):943-8. doi: 10.1093/ije/24.5.943.
Twins and triplets are at higher risk of cerebral palsy than singletons. This study investigated the degree of risk for cerebral palsy in twins, triplets and quadruplets, and identified factors associated with the increased risk.
The subjects were recruited from the Kinki University Twin and Higher Order Multiple Births Registry.
The subjects were 705 twins pairs (1410 twins), 96 sets of triplets (287 triplets excluding one infant death), and 7 sets of quadruplets (27 quadruplets excluding one infant death), who were born after 1977. The prevalence of cerebral palsy was 0.9% among 1410 twins, 3.1% among 287 triplets, and 11.1% among 27 quadruplets. Furthermore, the risks of producing at least one child with cerebral palsy were 1.5%, 8.0%, 42.9% in twin, triplet, quadruplet pregnancies, respectively. After adjusting for each associated factor using logistic regression, the risk of cerebral palsy was significantly associated with decrease in gestational age and asphyxia. The odds ratio indicated that infants whose gestational age was < 32 weeks were 20 times more likely to develop cerebral palsy than infants whose gestational age was > or = 36 weeks.
The prevalence of cerebral palsy in triplets and quadruplets was higher than that in twins. Lower gestational age was associated with a greater risk of cerebral palsy.
双胞胎和三胞胎患脑瘫的风险高于单胞胎。本研究调查了双胞胎、三胞胎和四胞胎患脑瘫的风险程度，并确定了与风险增加相关的因素。
研究对象来自近畿大学双胞胎及多胞胎登记处。
研究对象为1977年后出生的705对双胞胎（1410名双胞胎）、96组三胞胎（287名三胞胎，排除1例婴儿死亡）和7组四胞胎（27名四胞胎，排除1例婴儿死亡）。1410名双胞胎中脑瘫患病率为0.9%，287名三胞胎中为3.1%，27名四胞胎中为11.1%。此外，双胞胎、三胞胎、四胞胎妊娠中至少有一个孩子患脑瘫的风险分别为1.5%、8.0%、42.9%。使用逻辑回归对各相关因素进行校正后，脑瘫风险与孕周减少和窒息显著相关。优势比表明，孕周<32周的婴儿患脑瘫的可能性是孕周≥36周婴儿的20倍。
三胞胎和四胞胎中脑瘫的患病率高于双胞胎。孕周较低与患脑瘫的风险较高相关。
