晚期早产与早期足月双胎儿围生期情况差异的临床研究

张懿敏; 邵树铭; 张晓蕊; 刘捷; 曾超美

doi:10.7499/j.issn.1008-8830.2011126

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中国当代儿科杂志 ›› 2021, Vol. 23 ›› Issue (3) : 242-247. DOI: 10.7499/j.issn.1008-8830.2011126

论著·临床研究

晚期早产与早期足月双胎儿围生期情况差异的临床研究

张懿敏, 邵树铭, 张晓蕊, 刘捷, 曾超美

作者信息 +

Perinatal conditions of late preterm twins versus early term twins

ZHANG Yi-Min, SHAO Shu-Ming, ZHANG Xiao-Rui, LIU Jie, ZENG Chao-Mei

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文章历史 +

摘要

目的探讨晚期早产双胎新生儿（LPT）及早期足月双胎新生儿（ETT）围生期常见临床合并症情况。方法回顾性分析246例LPT及496例ETT孕母及新生儿期合并症情况，分析比较LPT发生的独立危险因素，并按胎龄分为34~34⁺⁶周组（n=44）、35~35⁺⁶周组（n=70）、36~36⁺⁶周组（n=132）、37~37⁺⁶周组（n=390）、38~38⁺⁶周组（n=106），比较各组新生儿围生期合并症情况。结果孕母妊娠高血压、孕母血小板减少、前置胎盘和胎膜早破为LPT发生的独立危险因素（P < 0.05）。LPT组呼吸系统疾病、喂养不耐受、低血糖症等发生率均高于ETT组（P < 0.05）。34~34⁺⁶周组新生儿窒息发生率高于37~37⁺⁶周组、38~38⁺⁶周组，败血症发生率高于36~36⁺⁶周组（P < 0.0045）；34~34⁺⁶周组、35~35⁺⁶周组新生儿呼吸窘迫综合征、新生儿呼吸暂停、新生儿贫血发生率均高于其他3组，新生儿肺炎、低血糖症、败血症发生率高于37~37⁺⁶周组、38~38⁺⁶周组（P < 0.0045）；35~35⁺⁶周组喂养不耐受发生率高于36~36⁺⁶周组、37~37⁺⁶周组、38~38⁺⁶周组（P < 0.0045）；36~36⁺⁶周组低血糖症发生率低于34~34⁺⁶周组，高于37~37⁺⁶周组（P < 0.0045）。结论相比于ETT，LPT围生期合并症发生率较高；不同胎龄LPT及ETT围生期合并症不同，应重视对不同胎龄双胎儿的个体化监测及合理治疗。

Abstract

Objective To study the perinatal complications of late preterm twins (LPTs) versus early term twins (ETTs). Methods A retrospective analysis was performed for the complications of 246 LPTs, 496 ETTs, and their mothers. The risk factors for late preterm birth were analyzed. According to gestational age, the twins were divided into five groups: 34-34⁺⁶ weeks (n=44), 35-35⁺⁶ weeks (n=70), 36-36⁺⁶ weeks (n=132), 37-37⁺⁶ weeks (n=390), and 38-38⁺⁶ weeks (n=106). The perinatal complications were compared between groups. Results Maternal hypertension, maternal thrombocytopenia, placenta previa, and premature rupture of membranes were independent risk factors for late preterm birth in twins (P < 0.05). The LPT group had higher incidence rates of respiratory diseases, feeding intolerance, and hypoglycemia than the ETT group (P < 0.05). The 34-34⁺⁶ weeks group had a higher incidence rate of neonatal asphyxia than the 37-37⁺⁶ weeks and 38-38⁺⁶ weeks groups; and had a higher incidence rate of septicemia than 36-36⁺⁶ weeks group (P < 0.0045). The 34-34⁺⁶ weeks and 35-35⁺⁶ weeks groups had higher incidence rates of neonatal respiratory distress syndrome, neonatal apnea, and anemia than the other three groups; and had higher incidence rates of neonatal pneumonia, hypoglycemia and septicemia than the 37-37⁺⁶ weeks and 38-38⁺⁶ weeks groups (P < 0.0045). The 35-35⁺⁶ weeks group had a higher incidence rate of feeding intolerance than the 36-36⁺⁶ weeks, 37-37⁺⁶ weeks, and 38-38⁺⁶ weeks groups (P < 0.0045). The 36-36⁺⁶ weeks group had a lower incidence rate of hypoglycemia than the 34-34⁺⁶ weeks group and a higher incidence rate of hypoglycemia than the 37-37⁺⁶ weeks group (P < 0.0045). Conclusions Compared with ETTs, LPTs have an increased incidence of perinatal complications. The incidence of perinatal complications is associated with gestational ages in the LPTs and ETTs.

导出引用

张懿敏, 邵树铭, 张晓蕊, 刘捷, 曾超美. 晚期早产与早期足月双胎儿围生期情况差异的临床研究[J]. 中国当代儿科杂志. 2021, 23(3): 242-247 https://doi.org/10.7499/j.issn.1008-8830.2011126

ZHANG Yi-Min, SHAO Shu-Ming, ZHANG Xiao-Rui, LIU Jie, ZENG Chao-Mei. Perinatal conditions of late preterm twins versus early term twins[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(3): 242-247 https://doi.org/10.7499/j.issn.1008-8830.2011126

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