体重不一致双胎早产儿的体重与新生儿并发症的相关分析

doi:10.12372/jcp.2025.24e1140

摘要/Abstract

摘要：

目的选择出生体重不一致双胎早产儿，评估出生体重与新生儿并发症的关系。方法 2018年1月至2024年5月，在新乡市三家医院出生后入住新生儿重症监护室(NICU)的体重不一致双胎早产儿共112对。将出生体重不一致的双胎儿分为体重大组(n=112)与体重小组(n=112)，比较其新生儿呼吸窘迫综合征(NRDS)等并发症发生情况与呼吸支持情况。结果体重小组的小于胎龄儿（SGA）较体重大组多，差异有统计学意义（P<0.001）；体重大组NRDS患病率较体重小组高（P<0.05），支气管肺发育不良（BPD）的发生率较体重小组低（P<0.05）。结论出生体重不一致双胎早产儿中，出生体重大者更易发生NRDS，出生体重小者更易患BPD。

关键词: 双胎, 出生体重不一致, 新生儿呼吸窘迫综合征, 支气管肺发育不良, 早产儿

Abstract:

Objective To select inconsistent birth weight twins who were preterm, and evaluate the relationship between birth weight and neonatal complications. Methods Twins with inconsistent birth weights who were admitted to the neonatal intensive care unit (NICU) in three hospitals in Xinxiang City from January 2018 to May 2024 were selected, totaling 112 pairs. The twins with inconsistent birth weights were divided into a higher birth weight group (n=112) and a lower birth weight group (n=112). The incidence of complications such as neonatal respiratory distress syndrome (NRDS) and respiratory support in both groups were compared. Results The lower birth weight group had more small-for-gestational-age (SGA) infants compared to the higher birth weight group, with a statistically significant difference (P<0.001). The incidence of NRDS in the higher birth weight group was higher than in the lower birth weight group (P<0.05), while the incidence of bronchopulmonary dysplasia (BPD) was lower in the higher birth weight group compared to the lower birth weight group (P<0.05). Conclusion In twins with inconsistent birth weights, those with higher birth weights are more likely to develop NRDS, while those with lower birth weights are more likely to develop BPD.

Key words: twins, birth weight discordance, neonatal respiratory distress syndrome, bronchopulmonary dysplasia, preterm infants

李祎展, 唐成和, 张明霞, 张有乐, 张卫星, 员丽. 体重不一致双胎早产儿的体重与新生儿并发症的相关分析[J]. 临床儿科杂志, 2025, 43(5): 329-333.

LI Yizhan, TANG Chenghe, ZHANG Mingxia, ZHANG Youle, ZHANG Weixing, YUAN Li. Correlation analysis of birth weight and neonatal complications in preterm twins with discordant birth weight[J]. Journal of Clinical Pediatrics, 2025, 43(5): 329-333.

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项目	体重大组(n=112)	体重小组(n=112)	统计量	P
性别[n(%)]
男	65(58.04%)	55(49.11%)	χ²=2.70	0.099
女	47(41.96%)	57(50.89%)	χ²=2.70	0.099
出生体重($\bar{x}±s$)/g	2277.0±478.5	1 772.4±434.7	t=17.51	<0.001
双胎之先分娩者[n(%)]	65(58.04%)	47(41.96%)	χ²=2.89	0.108
1 min Apgar评分≤7分[n(%)]	17（15.18%）	19（16.96%）	χ²=0.06	0.804
5 min Apgar评分≤7分[n(%)]	10（8.93%）	8（7.14%）	χ²=0.13	0.727
脐动脉血pH值[M(P₂₅~P₇₅)]	7.31（7.27~7.35）	7.32（7.28~7.35）	Z=0.65	0.516
SGA[n(%)]	6（5.36%）	47（41.96%）	χ²=39.09	<0.001

项目	体重大组(n=112)	体重小组(n=112)	统计量	P
新生儿窒息	20(17.86)	20(17.86)	χ²=0.06	1.000
NRDS	55(49.11)	40(35.71)	χ²=6.32	0.011
BPD	4(3.57)	13(11.61)	χ²=7.11	0.004
肺出血	1(0.89)	2(1.79)	χ²=0.00	1.000
新生儿肺炎	74(66.07)	75(66.96)	χ²=0.00	1.000
PPHN	1(0.89)	2(1.79)	χ²=0.00	1.000
NEC	4(3.57)	5(4.46)	χ²=0.00	1.000
PDA	29(25.89)	24(21.43)	χ²=2.28	0.125
ROP	3(2.68)	2(1.79)	χ²=0.00	1.000
败血症	23(20.54)	24(21.43)	χ²=0.00	1.000
贫血	40(35.71)	48(42.86)	χ²=1.44	0.229
使用PS	33(29.46)	24(21.43)	χ²=3.37	0.064
机械通气	8(7.14)	4(3.57)	χ²=1.50	0.219
CPAP	79(70.54)	79(70.54)	χ²=0.05	1.000
鼻导管吸氧	69(61.61)	69(61.61)	χ²=0.05	1.000