| Abstract | Cilj istraživanja: Odrediti je li pojava diskordantnog rasta blizanaca utječe na incidenciju prijevremenog porođaja (porođaj prije navršenog 37. gestacijskog tjedna). Ispitanice: U istraživanje su uključene rodilje koje su rodile blizance u razdoblju od 1. siječnja 2013. do 31. prosinca 2015. godine.
Rezultati: Prosječna dob trudnica koje su rodile blizance diskordantnog rasta bila je 31,4 ±5,6 godina, a kod trudnica koje su imale blizanačku trudnoću urednog rasta prosječna dob je bila 30,93 ±4,83 godina. Prosječna dob majki koje su zatrudnile uz pomoć MPO je 34,56 ±5,43 godina, a trudnica koje su zanijele prirodnim putem 30,63 ±4,56 godina. Nastup prijevremenog poroda značajno je češći u skupini trudnica s blizanačkom trudnoćom diskordantnog fetalnog rasta (p=0,029). Značajno više novorođenčadi iz skupine blizanačkih trudnoća urednog rasta ima zbroj po Apgar ljestvici >7 (p=0,004). Nije postojala statistički značajna razlika u učestalost dovršenja trudnoće carskim rezom u skupinama diskordantnih i konkordantnih trudnoća, kao ni u skupinama spontano zanešenih trudnoća i zanešenih pomoću medicinski potpomognute oplodnje (MPO). Nije postojala statistički značajna razlika u porodnoj masi između diskordantnih i konkordantnih blizanaca. Preeklampsija je značajno češća u trudnica starijih od 36 godina (p=0,031). Prijevremeni porodi značajno se češće dovršavaju carskim rezom nego terminski porodi (p=0,028), a nema razlike u načinu dovršetka trudnoće između skupina spontano zanešenih trudnoća i zanešenih pomoću MPO. Način zanošenja nema značajan utjecaj na pojavu diskordantnog fetalnog rasta u blizanačkim trudnoćama.
Zaključci: Prijevremeni porod češći je u skupini trudnica s blizanačkom trudnoćom diskordantnog fetalnog rasta. Nema značajne razlike u načinu dovršenja trudnoće između ispitivanih skupina. Blizanci diskordantnog rasta češće imaju zbroj po Apgarovoj ljestvici ≤7. Nije pronađena statistički značajna razlika u načinu dovršetka poroda između skupine spontano zanijetih i trudnoća zanijetih pomoću MPO. Način zanošenja nema statistički značajan utjecaj na pojavu diskordantnog fetalnog rasta u blizanačkim trudnoćama. U blizanačkih trudnoća, preeklampsija je značajno češća u trudnica starijih od 36 godina. |
| Abstract (english) | Objective: To determine the connection between discordant twin growth and incidence of preterm birth.
Design: Retrospectively analyzed delivery room birth protocols and medical histories in period from January 1st,2013 to December 31st,2015.
Settings and participants: The study included 217 women with twin pregnancies. 13 women were excluded from the sample due to death of one or both infants, or lack of medical documentation. Sample was divided in two groups- pregnancies with and without discordant twin growth.
Main Outcome Measures: Pregnancy duration and difference in infants' birthweight [(birthweight of lighter twin- birthweight of heavier twin)/ birthweight of heavier twin] expressed in percent.
Results: Average age of woment pregnant with discordant twins was 31,4 ±5,6 years, and of those pregnant with concordant twins 30,93 ±4,83 years. Average age of women who conceived by assisted reproductive technology (ART) was 34,56 ±5,43 years, and of those who spontaneously conceived 30,63 ±4,56 years.
Preterm birth was significantly more frequent in group of women pregnant with discordant twins (p= 0,0295). Twins with discordant growth had Apgar score ≤7 significantly more frequent than concordant twins (p=0,0047). There was no significant difference between two groups regardless of method of conception, as well as in groups of women who conceived spontaneously and those who conceived by ART. There was no significant difference in birthweight between groups of discordant and concordant twins.. Preeclampsia was significantly more frequent in women of age 36 and more (p=0,03132). Preterm births more frequently underwent Caesarean section than term births (p=0,02893). There was no significant difference in birth termination method between groups of women divided by conception method. Method of conception has no significant impact on occurence of discordant fetal growth in twin pregnancies.
Conclusions: Preterm birth was significantly more frequent in group of women with discordant fetal growth twin pregnancy. There was no significant difference between two groups regardless of birth termination method. Twins with discordant growth had Apgar score ≤7 significantly more frequent than concordant twins. There was no significant difference between groups of women who conceived spontaneously and those who conceived by ART regardless of method of conception. Preeclampsia was significantly more frequent in women of age 36 and more pregnant with twins. |
