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多胞胎的新生儿期并发症、结局及管理

Author
George T Mandy, MD
Section Editor
Leonard E Weisman, MD
Deputy Editor
Melanie S Kim, MD
Translators
姜红, 主任医师，教授

引言

多胞胎在美国呈增加趋势，并造成围生期和新生儿的并发症发病率和死亡率不成比例地增加。 (参见“围生期死亡率”，关于‘多胎妊娠’一节)

本文将总结多胞胎的并发症、结局及儿科管理。双胎妊娠、三胎妊娠和单羊膜囊双胎妊娠的产前管理将单独讨论。 (参见“双胎妊娠的产前问题”和“双胎妊娠：临产与分娩”和“单羊膜囊双胎妊娠”和“Triplet pregnancy”)

发生率

在美国，自然受孕的双胎妊娠和三胎妊娠的发生率分别约为1/80和1/8000[1,2]。不同国家的自然受孕双胎发生率有所不同，加拿大和中国南方较低[3,4]。

在发达国家，由于分娩时母亲年龄较大以及助孕治疗的广泛使用，多胎妊娠在总妊娠中的所占比例日趋增加[5,6]。在美国，36%的双胎妊娠及77%的三胎和高阶多胎妊娠发生在不孕症治疗之后[5]。 (参见“双胎妊娠的产前问题”，关于‘发生率和流行病学’一节)

在美国，双胎妊娠约占活产的3.4%，占多胎产的96%以上[7]。1980-2009年双胎妊娠的数量增加76%，并在2013年保持稳定，其出生率为33.7/1000[7]。1998年，三胞胎、四胞胎或更高阶多胎妊娠的发生率达峰值水平，为193.5/100,000，到2013年该比例降至119.5/100,000[7]。辅助生殖技术的改变使得三胞胎及更高阶多胎的出生率下降。 (参见“Strategies to control the rate of high order multiple gestation”, section on ‘Limiting the multiple gestation risk of ART’和“体外受精”，关于‘胚胎移植’一节)

                                       

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Literature review current through: 2017-06 . | This topic last updated: 2016-04-11.
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