早产双胞胎的分娩方式和后代的健康状况,一个回顾性队列研究
Itamar Ben Shitrit1,2,3,4, Eyal Sheiner5, Gali Pariente5
1Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. itamab@post.bgu.ac.il.
European journal of pediatrics
|March 10, 2025
概括
在早产双胞胎的剖腹产 (CD) 与后代的长期呼吸道,神经和传染性疾病的增加有关. 与剖腹产相比,阴道分娩可能为双胞胎提供潜在的健康益处.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿科学 新生儿科学
- 儿科健康结果的结果
背景情况:
- 剖腹产与单胎婴儿的潜在长期健康风险有关,但对早产双胞胎的影响不太清楚.
- 现有的关于CD和婴儿结局的研究不一致,特别是在早产方面,对双胞胎的数据有限.
- 尽管建议减少剖腹产,但剖腹产的高率仍然存在.
研究的目的:
- 研究早产双胞胎的分娩方式 (阴道分娩与剖腹产) 对健康的长期影响.
- 根据分娩方式,比较早产双胞胎中呼吸道,神经,传染病和胃肠道疾病的发生率.
主要方法:
- 在1991年至2021年间出生于高等医疗中心的早产双胞胎的回顾性队列研究.
- 排除具有先天性形或围产死亡的双胞胎.
- 使用卡普兰-梅尔生存曲线和考克斯比例危险模型进行分析,以评估累积发病率和调整混因素.
主要成果:
- 与阴道分娩 (VD) 双胞胎相比,通过剖腹产 (CD) 产生的早产双胞胎患上呼吸系统 (42%vs35%),神经系统 (22%vs17%) 和传染病 (69%vs62%) 的发病率更高.
- 调整后的危险比率 (aHR) 显示了CD与增加呼吸道 (aHR 1.15),神经系统 (aHR 1.16) 和传染病 (aHR 1.10) 发病风险之间的显著关联.
- 胃肠道疾病在CD组中比较普遍 (29%对25%),尽管在多变量分析中没有统计学意义 (aHR 1.10).
结论:
- 在早产双胞胎中,剖腹产与后代的长期呼吸,神经和传染性疾病的增加有关.
- 这些发现表明,阴道分娩与剖腹产相比,在早产双胞胎的长期健康并发症方面具有潜在的优势.
- 与剖腹产相关的高风险甚至在没有并发症的情况下也被观察到.
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