Objective: To study the association between maternal age and adverse pregnancy outcome in twin pregnancy.
Methods: The clinical data of 2 363 women with twin pregnancy from January 2006 to June 2016 were retrospectively reviewed. According to the age, the women were divided into six groups: <20 years (n=15), 20-24 years (n=158), 25-29 years (n=894), 30-34 years (n=936), 35-39 years (n=320), and ≥40 years group (n=40). The above groups were compared in terms of related baseline features and incidence rates of adverse pregnancy outcomes (preterm birth, birth defect, stillbirth in late pregnancy and small-for-gestational-age birth). A generalized estimating equation was used to investigate the risk of adverse pregnancy outcomes in different age groups.
Results: After control for the factors including place of residence, primipara, pregnancy pattern, and gestational diseases, the incidence rates of very preterm birth and moderately preterm birth in the ≥40 years group were 2.60 and 1.99 times than those in the 25-29 years group respectively (P<0.05). The incidence rates of very preterm birth and late preterm birth in the 20-24 years group were 1.99 and 1.33 times than those in the 25-29 years group respectively (P<0.05). The incidence rates of stillbirth in late pregnancy in the <20 years group, the 20-24 years group, and the ≥40 years group were 9.10, 2.88 and 3.97 times than those in the 25-29 years group respectively (P<0.05). The incidence rates of small-for-gestational-age birth in the <20 years group and the 35-39 years group were 2.70 and 0.73 times than those in the 25-29 years group respectively (P<0.05).
Conclusions: In twin pregnancy, pregnant women, aged <20 years, have a higher risk of smaller-for-gestational-age birth and stillbirth in late pregnancy, those aged ≥40 years have a higher risk of very preterm birth, moderately preterm birth and stillbirth in late pregnancy, and those aged 20-24 years have a higher risk of very preterm birth, late preterm birth and stillbirth in late pregnancy.
目的: 探讨双胎妊娠中母亲年龄和妊娠不良结局的关系。
方法: 回顾性纳入2006年1月至2016年6月住院分娩的双胎妊娠产妇2 363例的临床资料。按照产妇年龄不同分为 < 20岁（n=15）、20~24岁（n=158）、25~29岁（n=894）、30~34岁（n=936）、35~39岁（n=320）、≥ 40岁（n=40）6组。比较各年龄组产妇相关特征的基线，以及其妊娠不良结局（早产、出生缺陷、妊娠晚期死胎、小于胎龄儿）的发生率。采用广义估计方程，评估各年龄组妊娠不良结局发生的风险。
结果: 控制了居住地、是否初产妇、妊娠方式、孕产期相关疾病因素后，≥ 40岁组产妇的极早产儿和中期早产儿发生率分别是25~29岁组的2.60倍、1.99倍（P < 0.05）；20~24岁组极早产儿、晚期早产儿的发生率分别是25~29岁组的1.99倍、1.33倍（P < 0.05）； < 20岁、20~24岁、≥ 40岁组妊娠晚期死胎的发生率分别是25~29岁组的9.10倍、2.88倍、3.97倍（P < 0.05）； < 20岁、35~39岁组小于胎龄儿的发生率分别是25~29岁组的2.70倍、0.73倍（P < 0.05）。
结论: 双胎妊娠中， < 20岁的产妇发生小于胎龄儿和妊娠晚期死胎的风险较高，≥ 40岁的产妇发生极早产儿、中期早产儿和妊娠晚期死胎的风险较高，20~24岁产妇发生极早产儿、晚期早产儿和妊娠晚期死胎的风险较高。