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目的:探讨嘉定区双胎晚期早产儿的临床特点,为早期干预提供依据。方法:将2010年~2013年嘉定区妇幼保健院出生的188例妊娠双胎晚期早产儿(双胎组)与同期875例单胎晚期早产儿(单胎组)的一般情况、围产高危因素、新生儿疾病的发生情况进行比较。结果:双胎组的平均体重[(2 341.2±374.7)g vs(2 682.9±447.5)g]低于单胎组(P<0.01);小于胎龄儿发生率(12.8%vs 4.0%)高于单胎组(P<0.01);剖宫产率(90.4%vs 44.1%)高于单胎组(P<0.01);双胎组母亲妊娠期合并症贫血(78.7%vs 19.1%)、妊娠期高血压疾病(48.9%vs 9.0%)、胎膜早破(48.9%vs32.0%)、感染性疾病(23.4%vs 10.5%)、妊娠期糖尿病(17.0%vs 5.1%)、肝内胆汁瘀积症(12.8%vs 4.0%)、羊水过少(12.8%vs 5.5%)等发生率高于单胎组(P<0.01);双胎晚期早产儿的喂养不耐受(5.3%vs 1.7%)和颅内出血(5.3%vs1.9%)的发病率高于单胎组,高胆红素血症(3.7%vs 12.3%)的发生率低于单胎组(P<0.01)。结论:重视双胎妊娠,积极处理妊娠期高危因素,适当收紧剖宫产指征,以降低双胎晚期早产儿的近期新生儿疾病的风险。
Objective: To investigate the clinical features of preterm infants with twins in Jiading district in order to provide basis for early intervention. Methods: A total of 188 pregnant women with preterm twins (twins) born in Jiading District Maternal and Child Health Hospital from 2010 to 2013 were compared with 875 preterm singleton women (singletons) during the same period. The prevalence of perinatal high risk factors , The incidence of neonatal diseases were compared. Results: The average weight of the twins group was lower than that of the singleton group (2 341.2 ± 374.7 g vs 2 682.9 ± 447.5 g vs 12.8% vs 4.0%, P <0.01) (P <0.01). Cesarean section rate was higher (90.4% vs 44.1%) than singleton group (P <0.01). Pregnant rate was 78.7% (19.1%) in gestational age group (48.9% vs 9.0%), premature rupture of membranes (48.9% vs 32.0%), infectious diseases (23.4% vs 10.5%), gestational diabetes mellitus (17.0% vs 5.1%), intrahepatic bile (12.8% vs 4.0%) and oligohydramnios (12.8% vs 5.5%) were higher than those in singleton group (P <0.01). Feeding intolerance in preterm infants with twins (5.3% vs 1.7 The incidence of intracranial hemorrhage (5.3% vs 1.9%) was higher than that of singletons and hyperbilirubinemia (3.7% vs 12.3%) was lower than that of singletons (P <0.01). Conclusion: The importance of twin pregnancies, active management of high risk factors during pregnancy, cesarean section indications appropriate tightening to reduce the risk of neonatal diseases in the twins late premature children.