双胎妊娠早产的临床特点及早产儿结局分析  

Clinical characteristics of twin pregnancy complicated with preterm birth and analysis of preterm infants′ outcomes

作　　者：夏敏[1] 杨平[1] 崔伟[1] 李蕾[1] 王海宁[2] 全仁贵 宋玉春[2] 徐爱群[2] 

机构地区：[1]烟台毓璜顶医院妇产科,山东264000 [2]滨州医学院烟台附属医院妇产科,山东264100

出　　处：《中华妇幼临床医学杂志（电子版）》2016年第5期590-596,共7页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：山东省卫生计生委医药卫生科技发展计划项目(2011HZ118)~~

摘　　要：目的探讨双胎妊娠早产的临床特点及早产儿结局。方法选择2012年1月1日至2013年12月31日,在烟台毓璜顶医院和滨州医学院烟台附属医院产科住院分娩的双胎妊娠早产(孕龄为28~36+6孕周)均活产分娩的116例孕妇及其分娩的232例早产儿(均纳入双胎组),以及单胎妊娠早产均活产分娩的441例孕妇及其分娩的441例早产儿(均纳入单胎组)的临床病历资料为研究对象。采用回顾性分析方法,统计学比较两组孕妇临床特点及其分娩早产儿的临床结局差异,以及两组不同孕龄分娩早产儿的出生体重及出生体重Z评分值差异。结果 1两组孕妇的年龄、身高、入院体重、孕前与分娩时人体质量指数(BMI)、分娩孕龄及早产原因构成比比较,差异均无统计学意义(P>0.05)。双胎组孕妇孕期体重增加值、产前地塞米松(DEX)使用率(包括≤1个疗程DEX)及剖宫产率,均高于单胎组,入院孕龄小于单胎组,住院保胎时间长于单胎组,且差异均有统计学意义(P<0.05)。2双胎组孕妇分娩早产儿的出生体重及出生体重Z评分值较单胎组低,呼吸机使用时间较单胎组长,呼吸窘迫综合征(RDS)、肺炎、败血症、低血糖和贫血的发生率均较单胎组高,且差异均有统计学意义(P<0.05)。两组孕妇分娩早产儿的1min与5min Apgar评分、呼吸机使用率、低血钙发生率、平均住院天数及生后7d内死亡率比较,差异均无统计学意义(P>0.05)。3双胎组孕龄为35~35^(+6)孕周和36~36^(+6)孕周孕妇分娩早产儿的出生体重和出生体重Z评分值,均较同孕龄单胎组早产儿低,且差异有统计学意义(P<0.05);在其余各孕龄阶段,两组孕妇分娩早产儿的出生体重和出生体重Z评分值比较,差异均无统计学意义(P>0.05)。结论双胎妊娠是导致早产的重要原因,可对早产儿造成严重危害,应重视对双胎妊娠孕妇发生早产的防治。Objective To study the clinical features of twin pregnancy complicated with preterm birth and outcomes of preterm infants. Methods A study was conducted on 116 hospitalized cases of twin pregnancy with preterm birth and their 232 alive newborns with gestational age from 28 weeks to 36＋6 weeks （as twin pregnancy group）,who delivered in Yuhuangding Hospital and Yantai Affiliated Hospital of Binzhou Medical University from 1 January 2012 to 31 December 2013. Meanwhile another 441 cases of singleton pregnancy with preterm birth and their 441 alive newborns with the same gestational age were as singleton pregnancy group. Analyzed the general clinical data of all subjects by retrospective method. Statistical compared the differences of maternal clinical characteristics and outcomes of preterm infants between two groups, also the birth weight and the mean Z scores of birth weight of different gestational ages of preterm infants between two groups. Results （1）There were no significant differences between two groups in maternal age and height, weight on admission,pre-pregnancy body mass index（BMI） and prenatal BMI, the gestational age of delivery and constituent ratios of cause of preterm birth（P〈0.05）. The gestational weight gain, the prenatal usage rate of dexamethasone（DEX） （41 courses of DEX） and the rate of cesarean section of twin pregnancy group were higher than those of singleton pregnancy group, the gestational ages on admission and hospitalization time for tocolysis of twin pregnancy group were younger and longer than those of singleton pregnancy group and the differences were statistically significant （P〈 0.05）. （2） The birth weight and the mean Z scores of birth weight of preterm infants in twin pregnancy group were lower than those of singleton pregnancy group, the duration of ventilator use of preterm infants in twin pregnancy group was longer than that of singleton pregnancy group, and the rates of respiratory distress syndrome（RDS）, pneumonitis, sepsis, hypoglycem

关 键 词：双胎 早产 婴儿 早产 妊娠结局 

分 类 号：R722.6[医药卫生—儿科]