Yokoyama Y, Shimizu T, Hayakawa K
Department of Public Health, Kinki University School of Medicine, Osaka, Japan.
Acta Genet Med Gemellol (Roma). 1995;44(2):81-91. doi: 10.1017/s0001566000001744.
This study investigated the degree of risk of handicap in twins, triplets, quadruplets and quintuplets and associated factors, and examined the clustering tendency of handicaps. The sample was recruited from the Kinki University Twin and Higher Order Multiple Birth Registry. This panel consisted of 705 pairs of twins (1410 twins), 96 sets of triplets (287 triplets excluding 1 infant death), 7 sets of quadruplets (27 quadruplets excluding 1 infant death), and 2 sets of quintuplets (10 quintuplets), all of whom were born after 1977. The incidence of handicap was 3.7% in twins, 8.7% in triplets, 11.1% in quadruplets, and 10.0% in quintuplets. The risk of producing at least 1 handicapped child was approximately 1 in 13 pairs of twins (7.4%), 1 in 4 or 5 sets of triplets (21.6%), and 1 in 2 sets of quadruplet and quintuplets (50%). There was a significantly higher clustering tendency of handicaps in twins and triplets compared with the expected frequency calculated from the incidence rate of handicap. Four significant risk factors for subsequent handicap were found by logistic regression: gestation number, shortening of gestational age, premature rupture of the membrane, and toxemia during pregnancy.
本研究调查了双胞胎、三胞胎、四胞胎和五胞胎的残疾风险程度及相关因素，并研究了残疾的聚集倾向。样本来自近畿大学双胞胎及多胞胎登记处。该样本包括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）、7组四胞胎（27名四胞胎，排除1例婴儿死亡）和2组五胞胎（10名五胞胎），所有这些多胞胎均于1977年以后出生。双胞胎的残疾发生率为3.7%，三胞胎为8.7%，四胞胎为11.1%，五胞胎为10.0%。生育至少一名残疾儿童的风险在双胞胎中约为1/13对（7.4%），在三胞胎中约为1/4或1/5组（21.6%），在四胞胎和五胞胎中约为1/2组（50%）。与根据残疾发生率计算出的预期频率相比，双胞胎和三胞胎中残疾的聚集倾向明显更高。通过逻辑回归发现了四个导致后续残疾的显著风险因素：胎次、孕周缩短、胎膜早破和孕期毒血症。
