关键词: 双胎儿, 早产儿, 发育不均衡, 并发症, 神经发育

Abstract: Objective To study the early complications and neurological prognosis within 12 months of corrected age in twin preterms with birth weight discordance,in order to provide evidence for the prevention of complications in twin preterms with birth weight discordance. Methods A prospective cohort study was conducted.a total of 67 pairs of live twin preterms with birth weight discordance≥25% but without twin to twin transfusion syndrome hospitalized in the neonatal department of the Third Affiliated Hospital of Zhengzhou University from January 1,2016 to December 31,2017 were included,and were divided into low birth weight group and high birth weight group.The early complications and neurological prognosis within 12 months of corrected age were observed. Results 1)The rates of neonatal respiratory distress syndrome (NRDS),feeding intolerance and infectious diseases were significantly higher in the low birthweight group than in the high birth weight group (t=4.418,4.251,3.983,5.858,4.733,P<0.05).2)A total of 55 pairs of twins were both cured and 43 pairs were followed up to 12 months of correct age.In different gestational age groups (＜32 weeks,32-33⁺⁶ weeks and 34-36⁺⁶weeks),neonatal behavioral neurological assessment (NBNA) scores in low birthweight group were significantly lower than that of heavy birthweight group (t=4.850,3.269,3.381,P<0.05).There was no statistical difference in mental development index (MDI) between the two groups among different gestational age groups at 6 and 12 months of correct age respectively,while psychomotor development index (PDI) in the low birth weight group was lower than that of high birth weight group with statistical difference among different gestational age groups at 6 and 12 months of correct age (6months t=3.735,2.494,2.129;12months t=4.269,3.233,2.578,P<0.05). Conclusions In the twin preterms with birth weight discordance,those with low birthweight have more complications and a higher incidence of poor prognosis.Therefore,strict follow-up should be taken to those patients,and more attention should be paid to the psychomotor development.

Key words: twins, preterm, birth weight discordance, complications, neurological development