摘要目的 探讨双胎体重不均衡与母亲妊娠期合并症及新生儿疾病的关系.方法 回顾性分析2010-2011年在我院分娩、并住我院新生儿重症监护病房治疗的双胎,双胎新生儿体重差≥20％为体重不均衡组,＜20％为体重均衡组,比较两组母亲合并症情况及两组新生儿结局.结果 共纳入74对双胎,其中体重不均衡组31对,占41.9％,母亲合并妊娠期高血压综合征、胎膜早破、妊娠期肝内胆汁淤积症、妊娠期糖尿病的比例均明显高于体重均衡组[41.9％比16.3％,32.2％比9.3％,35.5％比11.6％,25.8％比7.0％,P＜0.05].体重不均衡组新生儿窒息、肺炎、高胆红素血症、呼吸窘迫综合征、贫血、红细胞增多症、喂养不耐受的发生率均高于体重均衡组[16.1％比4.6％,19.4％比4.6％,12.9％比3.5％,17.7％比4.6％,17.7％比5.8％,14.5％比3.5％,19.4％比4.6％,P＜0.05].Logistic多元回归分析显示,母亲合并妊娠期高血压综合征、肝内胆汁淤积症、糖尿病,以及新生儿窒息、肺炎、高胆红素血症、呼吸窘迫综合征、贫血、喂养不耐受均与双胎体重不均衡有关.结论 母亲妊娠期合并症与双胎体重不均衡有关,而双胎体重不均衡可能为新生儿疾病的影响因素.

abstractsObjective To study the relationship of twins with discordant birthweight and maternal complications during pregnancy,and the influence on neonatal disorders.Methods Retrospective analysis was conducted on twins delivered and admitted to NICU in our hospital in the year 2010 and 2011.Twins with birth weight difference ≥ 20％ were assigned to the discordant group,＜20％ to the balance group,maternal complications during pregnancy and neonatal disorder were compared between the two groups.Results A total of 74 pairs of twins were studied,including 31 (41.9％) in the discordant group,Maternal complications during pregnancy included hypertension,premature rupture of membranes,intrahepatic cholestasis of pregnancy and gestational diabetes.Which were higher in the discordant group than the balance group (41.9％ vs.16.3％,32.2％ vs.9.3％ vs.35.5％ vs.11.6％,25.8％ vs.7.0％,P ＜ 0.05).Neonatal disorders included neonatal asphyxia,pneumonia,hyperbilirubinemia,respiratory distress syndrome,anemia,polycythemia,feeding intolerance.The incidences of all of them were higher in the discordant group than that in he balance group (16.1％ vs.4.6％,19.4％ vs.4.6％,12.9％ vs.3.5％,17.7％ vs.4.6％,17.7％ vs.5.8％,14.5％ vs.3.5％,19.4％ vs.4.6％,P ＜ 0.05).Logistic regression analysis showed that hypertention during pregnancy,intrahepatic cholestasis of pregnancy,gestational diabetes,as well as neonatal asphyxia,neonatal pneumonia,neonatal hyperbilirubinemia,respiratory distress syndrome,neonatal anemia,feeding intolerance were related with discordant birthweight in twins Conclusion Discordant birthweight in twins were related with multiple complications during pregnancy and may influence the neonatal wellbeing.