双胎生长不一致和小于胎龄儿的流行病学调查研究  

Epidemiological investigation of inconsistent twin growth and smaller than gestational age

作　　者：苏莎[1] 龙玉[1] SU Sha;LONG Yu(The First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530021,China)

机构地区：[1]广西医科大学第一附属医院,广西南宁530021

出　　处：《现代医药卫生》2020年第9期1313-1316,共4页Journal of Modern Medicine & Health

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题项目(Z20180904)。

摘　　要：目的研究双胎生长不一致和小于胎龄儿(SGA)的流行病学情况。方法对2017年1月至2018年12月在该院出生的147对双胎临床特征进行回顾性分析,评估双胎生长不一致和双胎SGA的发病率及相关因素。结果双胎生长不一致为23对(15.65%),纳入双胎生长不一致组。双胎生长一致组(124例,84.35%)和双胎生长不一致组的单绒毛膜和双绒毛膜比较,差异无统计学意义(P>0.05)。高龄孕妇发生双胎生长不一致的概率升高,差异无统计学意义(P=0.102)。妊娠高血压和胎盘异常是双胎生长不一致的高危因素。双胎生长不一致与双胎红细胞压积(HCT)不一致呈较弱的正相关(r^2=0.103,P=0.000)。按照双胎的不同胎龄体重百分位图标准进行评判,SGA为40例(13.61%)。双胎生长不一致的小胎儿出生后发生SGA风险较高。结论双胎生长不一致需要临床重点关注,其中小胎儿发生SGA相关的不良结局概率增加。建议选取适合双胎的不同胎龄体重百分位图用于临床保健工作。Objective To study the epidemiological situation of inconsistent twin growth and smaller gestational age(SGA).Methods A retrospective analysis of the clinical characteristics of 147 twins born in the hospital from January 2017 to December2018 was performed to evaluate the inconsistent twin growth and the incidence of SGA and related factors.Results There were 23 pairs(15.65%)of inconsistent twin growth,which were included in the group of inconsistent twin growth.There was no significant difference in single chorion and double chorion in the twin growth uniform group(124 cases,84.35%)and the twin growth inconsistent group(P>0.05).The probability of inconsistent twin growth was increased in older pregnant women,and the difference was not statistically significant(P=0.102).Hypertensive disorders of pregnancy and abnormal placenta were high risk factors for inconsistent twin growth.Inconsistent twin growth was associated with a weak positive correlation with twin hematocrit(r^2=0.103,P=0.000).Judging according to different gestational age weight percentile standards for twins,SGA were 40 cases(13.61%).Small fetuses with inconsistent twin growth had a higher risk of SGA after birth.Conclusion Inconsistent twin growth requires clinical attention,and the probability of SGA-related adverse outcomes in small fetuses increases.It is recommended to select different gestational age weight percentile maps suitable for twins for clinical health care.

关 键 词：双胎 出生不一致 小于胎龄儿 

分 类 号：R715.5[医药卫生—妇产科学]