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目的:探讨双胎及单胎妊娠不同分娩孕周及出生体重围产儿死亡率及影响因素。方法:采用病例回顾性研究的方法,分析我院1989~1998年双胎妊娠155例及单胎妊娠10 599例围产儿死亡情况。结果:排除畸形死亡后,双胎围产儿总死亡率较单胎升高,差异有统计学意义(χ2=94.71,P<0.001)。在分娩孕周≥37周及32~36+6周,双胎围产儿死亡率高于单胎,差异有统计学意义(分别为χ2=9.85,P<0.01,χ2=7.61,P<0.01),而当分娩孕周<32周时,双胎围产儿的死亡率低于单胎,差异有统计学意义(χ2=12.93,P<0.0001)。在出生体重≥2 500 g时,双胎围产儿死亡率高于单胎,差异有统计学意义(χ2=9.06,P<0.01)。而当出生体重在1 500 g及<1 500 g时,则双胎儿与单胎围产儿死亡率差异无统计学意义(分别为χ2=0.182,P>0.05;χ2=1.536,P>0.05)。双胎或单胎围产儿死亡率均随分娩孕周及出生体重的增加而降低。结论:分娩孕周及出生体重是影响围产儿死亡率的重要原因。双胎围产儿宫内生长不同于单胎,尚需进一步研究适用于双胎妊娠的最佳分娩孕周及出生体重标准。
Objective: To investigate the perinatal mortality rate and its influencing factors in gestational age and birth weight in twin and singleton pregnancies. Methods: A case retrospective study was used to analyze the deaths of 155 twin pregnancies and 10 599 singleton pregnancies in our hospital from 1989 to 1998. Results: After excluding the deformity death, the total death rate of twins was higher than that of singletons (χ2 = 94.71, P <0.001). The mortality of twins was higher than that of singletons in gestational weeks ≥37 and weeks 32 ~ 36 + 6 (χ2 = 9.85, P <0.01, χ2 = 7.61, P <0.01) , While when the birth gestational age <32 weeks, the death rate of twins was lower than that of singleton, the difference was statistically significant (χ2 = 12.93, P <0.0001). At birth weight ≥2 500 g, the mortality rate of twins was higher than that of singletons (χ2 = 9.06, P <0.01). However, when birth weight was 1 500 g and <1 500 g, there was no significant difference in the mortality rate between twins and singleton infants (χ2 = 0.182, P> 0.05; χ2 = 1.536, P> 0.05). Twins or singleton perinatal mortality rates both decreased with gestational age and birth weight gain. Conclusion: The birth gestational age and birth weight are the important reasons that affect perinatal mortality. Twins perinatal intrauterine growth is different from the single-fetus, the need for further research applicable to twin pregnancy the best gestational gestational age and birth weight standards.