Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China
SHI Bi-Jun, LI Ying, WU Fan, FENG Zhou-Shan, CUI Qi-Liang, YANG Chuan-Zhong, YE Xiao-Tong, DAI Yi-Heng, LIANG Wei-Yi, YE Xiu-Zhen, MO Jing, DING Lu, WU Ben-Qing, CHEN Hong-Xiang, LI Chi-Wang, ZHANG Zhe, RONG Xiao, SHEN Wei, HUANG Wei-Min, YANG Bing-Yan, LYU Jun-Feng, HUANG Hui-Wen, HUO Le-Ying, RAO Hong-Ping, YAN Wen-Kang, REN Xue-Jun, YANG Yong, WANG Fang-Fang, LIU Dong, DIAO Shi-Guang, LIU Xiao-Yan, MENG Qiong, WANG Yu, WANG Bin, ZHANG Li-Juan, HUANG Yu-Ge, AO Dang, LI Wei-Zhong, CHEN Jie-Ling, CHEN Yan-Ling, LI Wei, CHEN Zhi-Feng, DING Yue-Qin, LI Xiao-Yu, HUANG Yue-Fang, LIN Ni-Yang, CAI Yang-Fan, HAN Sha-Sha, JIN Ya, LIU Guo-Sheng, WAN Zhong-He, BAN Yi, BAI Bo, LI Guang-Hong, YAN Yue-Xiu
Department of Pediatrics, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
Abstract：Objective To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. Methods A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. Results Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). Conclusions There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
SHI Bi-Jun,LI Ying,WU Fan et al. Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China[J]. CJCP, 2022, 24(1): 33-40.
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