小于胎龄三胞胎妊娠与新生儿死亡之间的关系:评价多胎妊娠生长情况的新方法

作     者：Blickstein I. Salihu H.M. Keith L.G. Alexander G.R. 刘凯 

作者机构：Department of Obstetrics and GynecologyKaplan Medical Center76100 RehovotIsrael Dr. 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第12期

页      面：51-51页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：多胎妊娠 胞胎 平均出生体重 子宫胎盘 妊娠组 替代指标 危险比 中位值 负相关 

摘      要：It is customary to estimate the uteroplacental function in singletons by defining appropriateness of birth weight by gestational age. Such a measure,however,is not available for the entire multiple pregnancy set. We evaluate a new index,total triplet birthweight,expressed as multiples of the median (MOM) birth weight of singleton gestations. We categorized triplet sets as small-,appropriate-,and large-for-gestational age pregnancies (SGA,AGA,and LGA,respectively),defined as1 SD from the mean MOM birth weight of singleton gestations. We used the 1995-1998 US matched multiple dataset to evaluate this index and to explore the association between the three categories in terms of risk of neonatal mortality. The mean ±SD MOM value was 2.3 ±0.4. There was an inverse correlation between mean MOM and gestational age. LGA pregnancy status was associated with multiparity,race (being white),and high social status (education). Maternal age did not influence MOM scores. Compared with the LGA pregnancy category,the risk for neonatal mortality was more than doubled in the AGA pregnancy group and more than 9-fold in the SGA pregnancy category. We propose that this new measure could be a useful proxy for the uteroplacental efficiency in a similar way that the SGA designation works for singleton infants.