Clinical study on independent risk factors and neonatal complications in discordant twins
10.3760/cma.j.issn.2095-428X.2019.08.013
- VernacularTitle:双胎发育不一致的独立危险因素及新生儿期合并症的临床研究
- Author:
Yimin ZHANG
1
;
Xiaorui ZHANG
;
Jie LIU
;
Chaomei ZENG
Author Information
1. 北京大学人民医院儿科 100044
- Keywords:
Discordant twins;
Twin pregnancy;
Complication;
Risk factor
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(8):614-617
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the perinatal independent risk factors and neonatal complications of discordant twins.Methods Clinical data of 152 (76 pairs) discordant twins and 552 (276 pairs) concordant twins were enrolled at the Obstetrics of Peking University People's Hospital from November 1,2011 to October 31,2016.The perinatal characteristics and the neonatal complications in 2 groups were analyzed and compared.Binary Logistic regression analysis was used to identify the independent risk factors associated with the occurrence of discordant twins.Results (1) The gestational age,the incidence of term infants and birth weight of the discordant twins were significantly lower than those of the concordant twins[(35.8 ±2.5) weeks vs.(36.7 ± 1.8) weeks,48.7％ vs.60.2％,(2 277.1 ± 575.7) g vs.(2 545.0 ± 413.4) g],and the differences were statistically significant (all P ＜ 0.05).The incidence of premature infants,the incidence of infants small for gestational age and the rate of transferring discordant twins to pediatric department were significantly higher than that of concordant twins (51.3％ vs.39.9％,40.8％ vs.13.2％,46.1％ vs.26.8％),and the differences were statistically significant (all P ＜ 0.05).(2) The incidence of neonatal asphyxia,neonatal respiratory distress syndrome,neonatal pneumonia,neonatal apnea,bronchopulmonary dysplasia,neonatal sepsis and neonatal intracranial hemorrhage were significantly higher than those of concordant twins (6.6％ vs.2.5％,7.2％ vs.3.1％,5.3％ vs.1.3％,9.2％ vs.3.3％,3.9％ vs.0.9％,3.3％ vs.0.7％,4.6％ vs.O.7％),and the differences were statistically significant(all P ＜ 0.05).(3) The birth weight in the twins with low body weight group was significantly lower than that in the twins with high body weight group [(1 926.7 ± 414.1) g vs.(2 618.7 ± 504.6) g],and the differences were statistically significant (P ＜ 0.05).The incidence of small for gestational age,the rate of conversion to pediatrics and the incidence of neonatal intracranial hemorrhage in the twins with low body weight group were significantly higher than those in the twins with high body weight group (65.8％ vs.6.6％,56.6％ vs.35.5 ％,9.2％ vs.0),and the differences were statistically significant (all P ＜ 0.05).(4) Logistic regression analysis showed that hypertensive disorder during pregnancy (OR =2.127,95％ CI:1.392-3.253) and gestational diabetes mellitus (OR =1.684,95％ CI:1.112-2.552) were independent risk factors for the occurrence of discordant twins.Conclusions Hypertensive disorder during pregnancy and gestational diabetes mellitus are independent risk factors for the occurrence of discordant twins,who are much more likely to develop various neonatal complications,particularly low-birth-weight infants.Timely surveillance and treatment of short-term complications and long-time follow-up are essential to discordant twins.
