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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >Second-trimester discordance and adverse perinatal outcome in twins: The STORK multiple pregnancy cohort
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Second-trimester discordance and adverse perinatal outcome in twins: The STORK multiple pregnancy cohort

机译：双胎妊娠中期不一致和围产期不良结果：STORK多胎队列研究

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Objective: The aim of this study was to determine the association between biometry discordance at the time of the anomaly scan and adverse perinatal outcomes in twin pregnancies. Design: Retrospective cohort study. Setting: Nine hospitals in the Southwest Thames Region of London Obstetric Research Collaborative (STORK). Population or sample: Population multicentre retrospective study of all twin pregnancies booked for antenatal care in nine hospitals over a period of 10 years. Methods: Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to evaluate the association between abdominal circumference (AC) and estimated fetal weight (EFW) discordance, recorded between 20 and 22 weeks of gestation, and adverse pregnancy outcomes. Main outcome measures: Stillbirth, neonatal mortality, preterm birth (PTB) at <34 weeks of gestation, and birthweight (BW) discordance ≥25%. Results: A total of 2399 twin pregnancies [457 monochorionic (MC) and 1942 dichorionic (DC)] were included in the study. The predictive accuracy of the EFW discordance was poor for fetal loss after 22 weeks of gestation (area under the curve, AUC 0.54, 95% CI 0.46-0.64), fetal loss beyond 28 weeks of gestation (AUC 0.42, 95% CI 0.31-0.52), perinatal loss (AUC 0.51, 95% CI 0.44-0.57), BW discordance (AUC 0.63, 95% CI 0.56-0.65), and PTB before 34 weeks of gestation (AUC 0.52, 95% CI 0.49-0.55). There was no significant difference in the prediction of these outcomes when using EFW discordance or AC discordance. Conclusions: Once structural malformations, chromosomal abnormalities, and twin-to-twin transfusion syndrome have been excluded, second-trimester EFW and AC discordance have poor predictive value for adverse perinatal outcomes in twin pregnancy.
机译：目的：本研究的目的是确定双胎妊娠中异常扫描时的生物统计学差异与不良围生期结局之间的关联。设计：回顾性队列研究。地点：伦敦西南泰晤士河地区产科研究合作组织（STORK）的9家医院。人口或样本：在10年中对九家医院进行产前护理的所有双胎妊娠进行的人口多中心回顾性研究。方法：进行逻辑回归和接收者操作特征（ROC）曲线分析，以评估腹围（AC）与估计的胎儿体重（EFW）不一致之间的关联，记录在妊娠20至22周之间以及不良妊娠结局。主要预后指标：死产，新生儿死亡率，妊娠<34周的早产（PTB）和出生体重（BW）不一致性≥25％。结果：共计2399例双胎妊娠[457单绒毛膜（MC）和1942绒毛膜（DC）]。 EFW不一致的预测准确性对于妊娠22周后的胎儿丢失（曲线下面积，AUC 0.54,95％CI 0.46-0.64），超过妊娠28周的胎儿丢失（AUC 0.42,95％CI 0.31-）很差。 0.52），围产期丢失（AUC 0.51，95％CI 0.44-0.57），BW不一致性（AUC 0.63，95％CI 0.56-0.65）和妊娠34周前的PTB（AUC 0.52，95％CI 0.49-0.55）。使用EFW不一致或AC不一致时，对这些结果的预测没有显着差异。结论：一旦排除了结构畸形，染色体异常和双胎输血综合征，双胎妊娠中晚期EFW和AC不一致性对围产期不良结局的预测价值较差。

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