出生体重不一致双胎新生儿并发症特点分析

Analysis of the Characteristics of Neonatal Complications in Twins with Inconsistent Birth Weight

目的:探讨出生体重不一致对双胎新生儿早期结局的影响,总结其临床特点,加强对出生体重不一致双胎新生儿的监护及干预。方法:收集2018年1月-2020年12月我院产科分娩双胎的282例产妇及其564例新生儿的临床资料,以新生儿双胎间出生体重差异是否≥20%分为出生体重不一致组(观察组)及出生体重一致组(对照组),比较两组新生儿母孕期一般情况、出生情况及新生儿期并发症差异。结果:⑴观察组新生儿出生体重、胎龄、1 min及5 min Apgar评分低于对照组,差异有统计学意义(P<0.05)。⑵观察组双胎早产发生率、低出生体重发生率、新生儿重症监护病房转入率均高于对照组,差异有统计学意义(P<0.05)。⑶观察组新生儿呼吸窘迫、新生儿颅内出血发生率均高于对照组,差异有统计学意义(P<0.05);观察组肺泡表面活性物质使用率及呼吸机使用率均高于对照组,差异有统计学意义(P<0.05)。⑷观察组中体重较小儿组出生平均体重小于体重较大儿组,低出生体重发生率高于体重较大儿组,住院平均天数高于体重较大儿组,差异均有统计学意义(P<0.05)。结论:出生体重不一致双胎新生儿胎龄小、早产率高、出生体重低,新生儿期疾病发病率高,尤其是双胎中体重较小者,应加强对出生体重不一致双胎母孕期、围产期及新生儿期的关注。

Objective To explore the effect of inconsistent birth weight on the early outcome of twins,summarize its clinical characteristics,and strengthen the monitoring and intervention of twins with inconsistent birth weight.Methods The clinical data of 282 pregnant women and 564 newborns who gave birth to twins in our hospital from January 2018 to December 2020 were collected.Based on whether the birth weight difference between twins was≥20%,they were divided into inconsistent birth weight group(observation group)and consistent birth weight group(control group).The differences of general situation,birth situation and neonatal complications between the two groups were compared.Results⑴The neonatal birth weight,gestational age,Apgar score at 1 min and 5 min in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).⑵The incidence of twin preterm birth,the incidence of low birth weight,and the transfer rate of neonatal intensive care unit in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).⑶The incidence rates of neonatal respiratory distress and neonatal intracranial hemorrhage in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).⑷In the observation group,the average birth weight of the smaller group was lower than that of the larger group,the incidence of low birth weight was higher than that of the larger group,and the average length of hospital stay was higher than that of the larger group,and the differences were statistically significant(P<0.05).Conclusion Inconsistent birth weight twins have small gestational age,high preterm birth rate,low birth weight,and high incidence of neonatal diseases,especially for twins with smaller birth weight.More attention should be paid to the pregnancy,perinatal and neonatal period of twin mothers with inconsistent birth weight.