双胎妊娠围产儿不良结局的影响因素分析

Analysis of risk factors for adverse perinatal outcomes of twins

摘要:

目的：探讨双胎妊娠围产儿不良结局的原因。方法：选取2013年1月1日至2013年12月31日在重庆市妇幼保健院住院分娩的双胎孕妇251例，回顾性分析孕妇及围产儿的临床资料，对影响围产儿不良结局的因素进行分析比较。结果：（1）251例双胎妊娠中，围产儿不良结局有87例，不良结局发生率高达34.66%，围产儿死亡21例，围产儿死亡率8.37%。（2）单因素分析结果：受孕方式、绒毛膜性、孕妇合并未足月胎膜早破、妊娠期糖尿病双胎妊娠围产儿结局有明显差异（P<0.050）。（3）多因素分析结果：剖宫产分娩是双胎围产儿结局的保护性因素（P=0.000，OR=0.086，95%CI=0.023~0.321）。未足月胎膜早破和单绒毛膜性是双胎妊娠围产儿结局不良的危险因素（P=0.010，OR=2.979；P=0.043，OR=5.689）。结论：单绒毛膜性、孕妇合并未足月胎膜早破双胎是双胎妊娠围产儿结局不良的主要危险因素，而分娩方式剖宫产术是保护性因素。

Abstract:

Objective：To analyze the risk factors for adverse perinatal outcomes of twins. Methods：The 251 cases of twin pregnancy in obstetric unit of Chongqing Health Center for Women and Children from January 1 2013 to December 31 2013 were enrolled in the retrospective study. Results：（1）The incidence of adverse perinatal outcomes of twins in the hospital was approximately 34.66%. The incidence of perinatal death was 8.37%.Single factor analysis：there were significant differences in fertilization way，chorionicity，preterm premature rupture of membranes，gestational diabetes（P<0.05）. （3）Logistic regression analysis：cescarean section is a protec－tive factors for perinatal outcomes of twins（P=0.000，OR=0.086，95%CI=0.023 to 0.321）. Preterm premature rupture of membranes（PPROM） and monochrionic twins are risk factors for adverse perinatal outcome（P=0.010，OR=2.979；P=0.043，OR=5.689）. Con－clusion：PPROM，monochorionic are the main risk factors for adverse perinatal twins while cesarean section is the protective factor.