Williams K, Hennessy E, Alberman E
Department of Epidemiology and Medical Statistics, St Bartholomew's & Royal London School of Medicine, London.
Arch Dis Child Fetal Neonatal Ed. 1996 Nov;75(3):F178-82. doi: 10.1136/fn.75.3.f178.
To determine the effects of birthweight and gestational age on the risk of cerebral palsy for multiple and singleton births.
Children on the North East Thames Regional Health Authority Interactive Child Health System, born between 1 January 1980 and 31 December 1986, and notified as having cerebral palsy, were included. Cases of postneonatal onset, of known progressive, or non-cerebral pathology and with only mild signs were excluded. Rates and relative risks were calculated using the most complete data, which related to 1985-86, and comprised 102,059 singletons and 2367 twins. Logistic regression was used to examine the associations between being a twin, gestational age, and birthweight.
The crude rate per 1000 survivors at 1 year of age was 1.0 in singletons and 7.4 in twins. The relative risk was greatest in twins weighing more than 2499 g (4.5). However, after adjusting for reduced birthweight of twins it was the relative risk of twins weighing less than 1400 g that was significantly increased. Logistic regression confirmed that lower fetal growth, lower gestational age, and being a twin are all independent risk factors for cerebral palsy.
The increased risk to twins of cerebral palsy is not entirely explained by their increased risk of prematurity and low birthweight.
确定出生体重和胎龄对多胞胎及单胞胎患脑瘫风险的影响。
纳入1980年1月1日至1986年12月31日期间在东北泰晤士河地区卫生局交互式儿童健康系统出生且被通报患有脑瘫的儿童。排除新生儿期后发病、已知进行性或非脑部病变且仅有轻微症状的病例。使用与1985 - 1986年相关的最完整数据计算发病率和相对风险，这些数据包括102,059名单胞胎和2367对双胞胎。采用逻辑回归分析双胞胎、胎龄和出生体重之间的关联。
单胞胎1岁时每1000名存活者的粗发病率为1.0，双胞胎为7.4。体重超过2499克的双胞胎相对风险最高（4.5）。然而，在对双胞胎出生体重降低进行校正后，体重低于1400克的双胞胎相对风险显著增加。逻辑回归证实，胎儿生长发育迟缓、胎龄较小和双胞胎身份都是脑瘫的独立危险因素。
双胞胎患脑瘫风险增加并非完全由其早产和低出生体重风险增加所致。
