脐血皮质醇的表达差异与双胎生长不一致的关系

The relationship between fetal cord blood cortisol expression difference and twins growth inconsistency

目的研究胎儿脐血皮质醇的表达差异与双胎生长不一致的关系。方法选取2021年1月至2022年12月于嘉兴市妇幼保健院诊断为双绒毛膜双胎的52对胎儿为研究对象,根据双胎出生体质量差是否≥15%将其分为DT组(胎儿生长不一致,25对)和CT组(胎儿生长一致,27对)。收集两组孕妇及胎儿的相关临床资料,比较两组孕妇、双胎胎儿间基本情况和两组胎儿脐血的皮质醇水平。结果两组孕妇的年龄、分娩孕周、产次、孕前体质量指数、受孕方式、分娩时间、双胎是否同性比较,差异均无统计学意义(P>0.05);DT组和CT组胎儿的羊水深度、脐动脉SD值、脐带绕颈情况、胎盘形状、双胎性别比较,差异均无统计学意义(P>0.05)。DT组低体质量胎儿的皮质醇水平显著高于高体质量胎儿(P<0.05),而CT组两胎儿的皮质醇水平比较差异无统计学意义(P>0.05)。结论双胎胎儿脐血中皮质醇水平的差异可能与双绒毛膜双胎胎儿生长不一致有关。

Objective To study the difference of cortisol expression in cord blood of twins with inconsistent growth.Methods Fifty-two pairs of dichorionic twins diagnosed in Jiaxing Maternity and Child Health Care Hospital from January 2021 to December 2022 were selected as study objects.The twins were divided into DT group(discordant fetal growth,25 pairs)and CT group(concordant fetal growth,27 pairs)according to whether the birth weight difference was≥15%.The clinical data of pregnant women and fetuses in two groups were collected,and the basic situation between pregnant women and twins and the levels of cortisol in fetal cord blood between twins of two groups were compared.Results There were no statistically significant differences between the two groups in age,gestational week,delivery time,pre-pregnancy body mass index,conception method,delivery time and sex of twins(P>0.05).There were no significant differences between DT group and CT group in amniotic fluid depth,umbilical artery SD value,umbilical cord around neck,placenta shape and twin sex(P>0.05).The low weight fetus in DT group had significantly higher cortisol levels than the high weight fetus(P<0.05),and there was no significant difference in cortisol levels between the two fetuses in CT group(P>0.05).Conclusion The differences in cortisol levels in the umbilical blood of twins may be related to the inconsistent growth of the fetus in dichorionic twins.