Perinatal factors and complications analysis of premature infants with birth weight discordant twins at different gestational ages
Wei Xian, Yang Shujie, Gan Bin,et al
(1. Department of Neonatology, Xiaogan Hospital Affiliated toWuhan University of Science and Technology, Hubei, Xiaogan 432000, China; 2. Department of Obstetrics, Xiaogan Hospital Affiliated to Wuhan University of Science and Technology, Hubei, Xiaogan 432000, China)
Abstract: 【Abstract】 Objective To explore the perinatal related factors and complications of premature infants with birth weight discordant twins (BWDT) at different gestational ages. Method The clinical data of born and surviving premature infants with BWDT and their mothers at Xiaogan Hospital Affiliated to WuhanUniversity of Science and Technology from January 2013 to December 2022 were retrospectively analyzed,and they were divided into <32 weeks group, 32-33+6 weeks group, and 34-36+6 weeks group according to different gestational ages, and analyze the relevant factors and complications of BWDT occurrence indifferent gestational age groups. The statistical methods performed by LSD-t test, one-way ANOVA, χ2 test,Fisher exact probability method, Logistic regression analysis and Bonferroni method. Result The average gestational age of 128 pairs of premature infants with BWDT was (34.5± 2.2) weeks, and the incidence ofpremature infants with BWDT was 13.1% (128/977), with 11.7% (15/128) in the <32 weeks group, 32.0%(41/128) in the 32-33+6 weeks group, and 56.3% (72/128) in the 34-36+6 weeks group. The proportion ofpregnant women with gestational hypertension in the 34-36+6 weeks group was significantly higher than thatin the <32 weeks group and the 32-33+6 weeks group [48.8% (35/72) vs 20.0% (3/15), 26.8% (11/41)], and thedifference was statistically significant (P<0.017). The incidence of placental abnormalities in the <32 weeksgroup was significantly higher than that in the 32-33+6 weeks group and the 34-36+6 weeks group [73.3%(11/15) vs 39.0% (16/41) and 34.7% (25/72)], the incidence of umbilical cord abnormalities in the <32 weeksgroup was significantly higher than that in the 32-33+6 weeks group and the 34-36+6 weeks group[40.0%(6/15) vs 14.6% (6/41), 12.5% (9/72)], and the differences were statistically significant (all P<0.017). Afteradjusting for factors related to disease occurrence, Logistic regression analysis showed that the risk of BWDT was significantly increased in women with gestational hypertension (OR=1.452, 95% CI: 1.268-6.703, P=0.041). There was no significant increase in the risk of placental and umbilical cord abnormalities(all P>0.05). In premature infants with BWDT, the incidence of feeding intolerance in the <32 weeks groupwith small birth weight was significantly higher than that in the 32-33+6 weeks group and the 34-36+6 weeks group [73.3% (11/15) vs 26.8% (11/41), 12.5% (9/72)]. The incidence of brain injury in the <32 weeks group with small birth weight was significantly higher than that in the 34-36+6 weeks group [40.0% (6/15) vs 11.1% (8/72)], the incidence of small for gestational age infant in the 34-36+6 weeks group with small birth weight was significantly higher than that in the <32 weeks group and 32-33+6 weeks group [54.2% (39/72) vs 20.0% (3/15), 19.5% (8/41)], the differences were statistically significant (all P<0.017). Conclusion The risk of late premature infants with BWDT is higher. The placental and umbilical cord factors play an important role in the occurrence of BWDT in early preterm infants, while gestational hypertension has a greater impact on the occurrence of BWDT in late preterm infants, and gestational hypertension can serve as an independent risk factor affecting the occurrence of BWDT. Early preterm infants with BWDT are more prone to feeding intolerance and brain damage in those with small birth weight, while late preterm infants have a higher risk of small for gestational age infant.
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Wei Xian, Yang Shujie, Gan Bin, et al. Perinatal factors and complications analysis of premature infants with birth weight discordant twins at different gestational ages. Journal of Developmental Medicine(Electronic Version), 2025, 13(1): 11-18.
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