双子の妊娠における子宮内死亡の結果
1Department of Public Health, University of Liverpool, UK. p.o.d.pharoah@liv.ac.uk
Lancet (London, England)
|May 23, 2000
まとめ
子宮内で死亡した胎児の生き残った双子は,脳障害のリスクが高く,全体のリスクは20%です. この研究では,共生双子の生存者に対する重大なリスクが定量化され,意識とモニタリングの必要性を強調しています.
科学分野:
- ペリナトロジー (Perinatology) とは
- ネオナタロジー (新生児科学)
- エピデミオロジー エピデミオロジー
背景:
- 双子の妊娠は,シングルトンの妊娠と比較して,より高い死亡率と罹病率のリスクを伴う.
- 子宮内で死亡した胎児の生存共同双子は,特にリスクが高い.
研究 の 目的:
- 子宮内胎児死亡を経験した共同双子の生存者の死亡率と重篤な罹患率を定量化するために.
- 双子の子宮内死亡後に生まれた乳児における脳障害のリスクを評価する.
主な方法:
- イギリスとウェールズ (1993年−1995年) の双子の出産のデータを用いてコホート研究が行われました.
- 死亡証明書と全般医療専門医のアンケートを使用して,生き残った双子の死亡率と障害に関するデータを収集しました.
- フォローアップデータは,子宮内で死亡した胎児の生児共同双生児について収集されました.
主要な成果:
- 同性双子の場合,脳性麻痺の罹患率は1000人当たり106人,その他の脳機能障害の罹患率は1000人当たり114人でした.
- 異性双子の場合,脳性麻痺の罹患率は1000人当たり29人,その他の脳機能障害の罹患率は1000人当たり118人でした.
- 子宮内胎児死亡後の生児共同双子の脳機能障害の全体的なリスクは20%でした.
結論:
- 子宮内で死亡する胎児の生後双生児は,脳機能障害のリスクが高くなります.
- これらの乳児の脳性麻痺の罹患率は,一般的な双子の集団よりも著しく高い.
- 脳性麻痺の妊娠年齢特有のリスクは,子宮内で同胞が死亡した後に顕著に上昇します.
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