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目的探讨双胎妊娠分娩时机及分娩方式与新生儿窒息之间的关系。方法回顾性分析2013年7月-2016年6月在该院住院的双胎妊娠孕妇540例,统计各孕周分娩比例;比较各孕周新生儿出生体重及新生儿窒息发生率。结果 540例双胎妊娠中,早产323例,早产率59.81%,主要集中在妊娠36~37~(+6)周;28周后活产新生儿平均体重:大胎儿(2 407.85±446.86)g,小胎儿(2 138.00±445.31)g;活产新生儿窒息发生率:大胎儿2.04%(11/539),小胎儿6.43%(34/529)。32~33~(+6)周、28~33~(+6)周阴道分娩组和剖宫产组新生儿窒息率比较,差异有统计学意义(P<0.05);28~33~(+6)周阴道分娩组和剖宫产组小胎儿窒息发生率比较,差异有统计学意义(P<0.05);34~35~(+6)周剖宫产组大胎儿和小胎儿窒息发生率比较,差异有统计学意义(P<0.05);28~31~(+6)周阴道分娩组大胎儿和小胎儿窒息发生率比较,差异有统计学意义(确切概率P=0.033),32~33~(+6)周组和34~35~(+6)周组新生儿窒息发生率比较,差异有统计学意义(P<0.05)。结论双胎妊娠32~33~(+6)周终止妊娠,剖宫产新生儿窒息发生率低于阴道分娩,可改善小胎儿的妊娠结局。
Objective To investigate the relationship between twins delivery timing and mode of delivery and neonatal asphyxia. Methods A retrospective analysis of 540 pregnant women with twins who were hospitalized in our hospital from July 2013 to June 2016 was conducted. The proportions of delivery during each gestational week were calculated. The birth weight and neonatal asphyxia of each newborn were compared. Results Among the 540 cases of twin pregnancies, 323 cases were premature birth with a premature birth rate of 59.81%, mainly in the 36th to 37th week (+6) weeks of pregnancy. The average live weight of newly born infants after 28 weeks was (2 407.85 ± 446.86) g (2 138.00 ± 445.31) g. The incidence of neonatal asphyxiation was 2.04% (11/539) in big fetus and 6.43% (34/529) in small fetus. The difference was statistically significant (P <0.05) between 28 ~ 33 ~ (+6) weeks and 28 ~ 33 ~ (+6) weeks in vaginal delivery group and cesarean section group; 28 ~ 33 ~ 6) There was a significant difference in the incidence of small fetuses asphyxial between the vaginal delivery group and the cesarean section (P <0.05). The incidence of fetal asphyxia in the cesarean section between 34 and 35 (+6) weeks (P <0.05). The incidence of big fetus and small fetus asphyxia in vaginal delivery between 28 ~ 31 ~ (+6) weeks was significantly different (P = 0.033), and the difference was statistically significant The incidence of asphyxia in 33 ~ (+6) weeks group and 34 ~ 35 ~ (+6) weeks group was statistically significant (P <0.05). Conclusion Twin pregnancy termination of pregnancy 32 ~ 33 ~ (+6) weeks, the incidence of cesarean section neonatal asphyxia is lower than vaginal delivery, can improve the fetus’s pregnancy outcome.