Risk factors of birth weight discordance in dichorionic diamniotic twin pregnancies: analysis of 1 757 cases
10.3760/cma.j.cn113903-20200513-00449
- VernacularTitle:双绒毛膜双羊膜囊双胎出生体重不均衡的危险因素：1 757例分析
- Author:
Xi CHEN
1
;
Hong WANG
;
Xiaotian LI
;
Fanhua SHI
;
Wenrong WANG
;
Guichun DING
;
Xiaoping FEI
;
Xiahong WANG
;
Meihua ZHANG
;
Shufang YU
;
Yang PENG
;
Hongbo WU
;
Xiaoyan CHENG
Author Information
1. 复旦大学附属妇产科医院产科，上海 200011（现在复旦大学附属妇产科医院妇产科，上海 200011）
- From:
Chinese Journal of Perinatal Medicine
2020;23(10):695-701
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors of birth weight discordance in dichorionic diamniotic (DCDA) twins.Methods:This study retrospectively analyzed 1 757 cases of DCDA twin pregnancies from 11 Chinese hospitals from January 1, 2014, to December 31, 2017. Birth weight discordance was defined as ≥ 20% difference between the twins. All cases were divided into two groups: the concordant group ( n=1 520) and discordant group ( n=237). General information was compared and the high-risk factors of birth weight discordance were analyzed. Mann-Whitney U test, Chi-square test or Fisher's exact test, and logistic regression analysis were used as statistical methods. Results:Compared with the concordant group, the discordant group showed a higher incidence of hypertensive disorders of pregnancy [24.5% (58/237) vs 12.8% (194/1 520), χ2=22.882, P<0.05], fetal structural malformations [4.2% (10/237) vs 1.0% (15/1 520), χ2=15.160, P<0.05], fetal distress [6.3% (15/237) vs 1.4% (21/1 520), χ2=22.602, P<0.05], umbilical cord abnormalities [3.8% (9/237) vs 1.2% (18/1 520), χ2=7.607, P<0.05] and abnormal placental cord insertion [3.8% (9/237) vs 1.4% (21/1 520), χ2=34.904, P<0.05], but lower incidence of premature rupture of membranes [11.0% (26/237) vs 16.5% (250/1 520), χ2=4.645, P=0.034]. Logistic regression analysis showed that the independent risk factors of birth weight discordance in DCDA twins were hypertensive disorders of pregnancy ( OR=2.258, 95% CI: 1.620-3.184, P<0.001), fetal structural malformations ( OR=4.268, 95% CI: 1.892-9.631, P<0.001), umbilical cord abnormalities ( OR=2.889, 95% CI: 1.245-6.705, P=0.014) and abnormal placental cord insertion ( OR=2.318, 95% CI: 1.012-5.311, P=0.047). Conclusions:Hypertensive disorders of pregnancy, fetal structural malformations, umbilical cord abnormalities and abnormal placental cord insertion may be the risk factors of birth weight discordance in DCDA twins.
