摘要
目的比较辅助生殖技术下单双胎活产新生儿以及不同发育类型双胎新生儿在出生体重的百分位数及增长趋势,绘制胎龄别出生体重曲线,为临床识别高危双胎和评估双胎发育情况提供依据。方法利用辅助生殖中心出生资料中的胎龄和出生体重数据,绘制辅助生殖单胎(n=5462)和双胎(n=2580)胎龄-出生体重增长趋势图。进一步对双胎进行分层,以同胞双胎儿出生体重差异≥25%为双胎发育不一致的诊断标准,描述一致型双胎和不一致型双胎胎儿的出生体重的百分位数及增长趋势图。结果辅助生殖技术下双胎的发生率为32.1%。与单胎相比,辅助生殖技术双胎胎儿的大胎和小胎的出生体重中位数达到或超过2500 g的标准时间分别落后1周和3周,进一步对双胎发育类型分层,发现一致型双胎的大胎和小胎出生体重中位数分别在孕36和37周达到2500 g,不一致型双胎的大胎可在孕35周达到2500 g,小胎则在孕39周仍无法达到2500 g(2300 g)。此外,曲线拟合模型显示,双胎中的大胎在孕37周后,出生体重有趋近单胎的趋势,对不同发育类型的双胎进行分析,一致型大胎在孕37周后出生体重有趋近不一致型大胎的趋势,但小胎仍表现为持续落后。结论辅助生殖技术下双胎体重的增长和单胎存在差异,且与孕周、是否为一致型双胎相关,因此临床上对双胎的发生、终止妊娠时间的选择、双胎胎儿发育及预后评判需要综合评价。
Objective To compare the birth weight of singleton and twins,as well as different developmental type of twins in assistant reproductive technology(ART),thus to provide evidences for clinical practice.Methods This study recruited 8042 ART pregnant women,whose child born at gestation between 27-40 weeks.The gestational age and child birth weight were collected.Taking singleton as control group(n=5462),percentile for birth weight of both singleton and twins were calculated.Twins those had intra-pair birth weight difference over 25%were classified as discordant twins,and percentile for birth weight of both identical twins and discordant twins were calculated.Results In ART,the prevalence of twins were 32.1%.Compared with singleton,the median birth weight of twin(big)and twin(small)had either 1 week or 3 weeks delay in reaching 2500 g.Stratified by twin type,identical twins'median birth weight reached 2500 g at the 36th(big)or 37th(small)week;the big discordant twin'median birthweight could reach 2500 g at the 35th week.However,the small discordant twin could not reach 2500 g even at the 40th week.Curve fitting model showed that the big twin's birth weight had a trend to catch up with singleton after 37th week,as well as the big child of identical twin showed a trend to catch up with the big child of discordant twins.But regardless of twin's type,the small children in a twin pair always showed birth weight growth delay.Conclusion Birth weight growth of twins is associated with gestational week.In clinical practice,to evaluate the prevalence of twin,fetus development,time to terminate pregnancy and prognoses,doctors should take the mentioned factors into account.
作者
钟鑫琪
梁少珍
曹牧青
谭小华
刘海英
林燕珊
ZHONG Xin-qi;LIANG Shao-zhen;CAO Mu-qing;TAN Xiao-hua;LIU Hai-ying;LIN Yan-shan(Department of Neonatology,Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,Guangdong,China;不详)
出处
《广东医学》
CAS
2020年第14期1480-1484,共5页
Guangdong Medical Journal
基金
国家自然科学基金(81801532,81903337)
广东省自然科学基金(2018A030310188)。
关键词
辅助生殖技术
双胎
出生体重
生长趋势
assistant reproductive technology
twins
birth weight
growth trend
