254例双胎新生儿不良结局危险因素分析

Risk factors for adverse neonatal outcomes in 254 twins

目的探讨双胎新生儿不良结局的危险因素,为提高双胎新生儿的存活及改善预后提供参考。方法收集2005年1月至2009年12月入住我科的254例双胎新生儿临床资料进行回顾性分析,分析不良结局的危险因素。结果 254例双胎儿中,84例有不良结局(33.1%),其中死亡10例(3.9%)。多因素分析结果显示通过辅助生殖技术受孕是不良结局的保护因素(OR=0.389,P<0.05);胎龄(≤34周)、脐带异常、羊水粪染和5minApgar评分≤7是不良结局的独立危险因素(OR分别为4.434、4.731、3.424、18.958,P<0.05)。结论胎龄≤34周、脐带异常、羊水粪染或5minApgar评分≤7的双胎儿易出现新生儿期不良结局。

Objective The aim of this study was to identify the risk factors for adverse neonatal outcome in twins in order to provide a basis for the improvement of the survival and neonatal outcomes of twins. Methods Data from 254 twins admitted to Nanfang Hospital of Southern Medical University From January 2005 to December 2009 were retrospectively studied. Risk factors for adverse neonatal outcomes were assessed by logistic regression analysis. Results Of the 254 twins,84 （ 33. 1% ） had an adverse outcome,including 10 （ 3. 9% ） neonatal deaths. Logistic regression analysis demonstrated that gestational age （ ≤34 weeks） ,cord abnormalities,meconium-stained amniotic fluid and 5-min Apgar scores （ ≤7 ） were independent risk factors for adverse neonatal outcomes （ OR = 4. 434,4. 731,3. 424,18. 958, respectively; P = 0. 021,0. 001,0. 037,0. 011,respectively） . Conception by assisted reproductive technology was shown as a protective factor for adverse neonatal outcomes （ OR = 0. 389,P = 0. 037） . Conclusions The twins with gestational age ≤34 weeks,cord abnormalities,meconium-stained amniotic fluid or 5-min Apgar scores （ ≤7） are subject to adverseneonatal outcome.