Luke B, Leurgans S, Keith L, Keith D
Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, USA.
Acta Genet Med Gemellol (Roma). 1995;44(3-4):169-78. doi: 10.1017/s0001566000001586.
The objective of this study was to assess the childhood growth of twin children in terms of the effects of intrauterine growth retardation (IUGR) and discordancy at birth on the incidence and severity of stunting and discordancy in current height and weight. The study was part of a cross-sectional field project conducted at the Annual Twins Days Festival in Twinsburg. Ohio, USA, during 1990, 1991, and 1993, and including all twin children between 2 and 12 years of age. Mothers of twins were interviewed regarding their children's birthweights and gestational age; the twin children were measured for their current heights and weights. The study population included 990 twin children, including 555 boys and 435 girls, of which there were 254 boy pairs and 194 girls pairs. Birthweight for gestational age and current weight and height were each converted into Z-scores and characterized as severe (Z-score < -2,0), or moderate IUGR or stunting (Z-score > -2.0 and < -1.2). For the present study discordancy in birthweight, and current height and weight was calculated for like-gender twin pairs. Only twin children with severe IUGR at birth showed an increased risk of stunting in their current height or weight, and this risk was only for moderate, not severe, stunting. Boy twins with severe IUGR at birth were at increased risk of moderate stunting in their current weight (OR 2.67, 95% CI 1.55, 4.58, p = 0.002), while girl twins with severe IUGR at birth were at increased risk of moderate stunting in their current height (OR 4.09, 95% CI 1.49, 10.99, p = 0.003). Among like-gender twin pairs, there were no differences in mean or categories of birthweight or current weight discordancy, but boy twin pairs did show a significantly greater proportion of current weight discordancy compared to girl twin pairs (p = 0.005). Overall, there was a significant tendency for differences in height and weight between like-gender twin pairs to disappear over time, with the effect being greater for boy twin pairs. We conclude from these findings that twin children tend to overcome growth retardation and discordancy present at birth, and although children who had severe IUGR or discordancy at birth were more likely to have some residual moderate stunting or discordancy in height or weight, they still tended to be within normal values for their gender and current age.
本研究的目的是评估双胞胎儿童的童年生长情况,具体涉及宫内生长迟缓(IUGR)和出生时的不一致对发育迟缓的发生率和严重程度以及当前身高和体重不一致的影响。该研究是在美国俄亥俄州特温斯堡年度双胞胎节期间开展的一项横断面实地项目的一部分,时间跨度为1990年、1991年和1993年,涵盖了所有2至12岁的双胞胎儿童。研究人员就双胞胎的出生体重和孕周对其母亲进行了访谈;并测量了双胞胎儿童当前的身高和体重。研究对象包括990名双胞胎儿童,其中有555名男孩和435名女孩,其中男孩双胞胎对有254对,女孩双胞胎对有194对。将出生体重与孕周的关系以及当前体重和身高分别转换为Z评分,并将其定义为严重(Z评分<-2.0)、中度IUGR或发育迟缓(Z评分>-2.0且<-1.2)。在本研究中,计算了同性双胞胎对在出生体重、当前身高和体重方面的不一致情况。只有出生时患有严重IUGR的双胞胎儿童在当前身高或体重方面出现发育迟缓风险增加,且这种风险仅针对中度而非严重发育迟缓。出生时患有严重IUGR的男双胞胎在当前体重方面出现中度发育迟缓的风险增加(比值比2.67,95%置信区间1.55,4.58,p = 0.002),而出生时患有严重IUGR的女双胞胎在当前身高方面出现中度发育迟缓的风险增加(比值比4.09,95%置信区间1.49,10.99,p = 0.003)。在同性双胞胎对中,出生体重或当前体重不一致的平均值或类别没有差异,但与女双胞胎对相比,男双胞胎对当前体重不一致的比例显著更高(p = 0.005)。总体而言,同性双胞胎对之间身高和体重的差异有随时间消失的显著趋势,对男双胞胎对的影响更大。从这些研究结果中我们得出结论,双胞胎儿童往往会克服出生时存在的生长迟缓与不一致情况,尽管出生时患有严重IUGR或不一致的儿童更有可能在身高或体重方面存在一些中度发育迟缓或不一致的残留情况,但他们的身高和体重仍倾向于处于其性别和当前年龄的正常范围内。