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Objective:To investigate the risk factors of birth weight discordance in dichorionic diamniotic (DCDA) twins.Methods:This study retrospectively analyzed 1 757 cases of DCDA twin pregnancies from 11 Chinese hospitals from January 1, 2014, to December 31, 2017. Birth weight discordance was defined as ≥ 20% difference between the twins. All cases were divided into two groups: the concordant group ( n=1 520) and discordant group ( n=237). General information was compared and the high-risk factors of birth weight discordance were analyzed. Mann-Whitney U test, Chi-square test or Fisher's exact test, and logistic regression analysis were used as statistical methods. Results:Compared with the concordant group, the discordant group showed a higher incidence of hypertensive disorders of pregnancy [24.5% (58/237) vs 12.8% (194/1 520), χ2=22.882, P<0.05], fetal structural malformations [4.2% (10/237) vs 1.0% (15/1 520), χ2=15.160, P<0.05], fetal distress [6.3% (15/237) vs 1.4% (21/1 520), χ2=22.602, P<0.05], umbilical cord abnormalities [3.8% (9/237) vs 1.2% (18/1 520), χ2=7.607, P<0.05] and abnormal placental cord insertion [3.8% (9/237) vs 1.4% (21/1 520), χ2=34.904, P<0.05], but lower incidence of premature rupture of membranes [11.0% (26/237) vs 16.5% (250/1 520), χ2=4.645, P=0.034]. Logistic regression analysis showed that the independent risk factors of birth weight discordance in DCDA twins were hypertensive disorders of pregnancy ( OR=2.258, 95% CI: 1.620-3.184, P<0.001), fetal structural malformations ( OR=4.268, 95% CI: 1.892-9.631, P<0.001), umbilical cord abnormalities ( OR=2.889, 95% CI: 1.245-6.705, P=0.014) and abnormal placental cord insertion ( OR=2.318, 95% CI: 1.012-5.311, P=0.047). Conclusions:Hypertensive disorders of pregnancy, fetal structural malformations, umbilical cord abnormalities and abnormal placental cord insertion may be the risk factors of birth weight discordance in DCDA twins.
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Objective:To compare the differences of pregnancy complications, perinatal outcomes and mode of delivery between the elderly and the right-age mothers.Methods:A retrospective analysis was conducted on 1 303 elderly women who were hospitalized and delivered in the obstetrics department of the First People′s Hospital of Kunshan City from December 2016 to February 2017. Among them, 1 139 cases aged 35-39 years were selected as study group 1 and 164 cases ≥40 years old as study group 2. The differences of pregnancy complications, perinatal outcomes and delivery modes among the three groups were analyzed.Results:Compared with the control group, pregnancy-induced hypertension, gestational diabetes mellitus, hypothyroidism, placenta previa, uterine fibroids, premature delivery, fetal distress, macrosomia and cesarean section rates in the study group were significantly higher ( P<0.05). There were no significant difference in intrahepatic cholestasis of pregnancy, premature rupture of membranes, postpartum hemorrhage, ovarian cyst, fetal growth restriction and stillbirth among the groups ( P>0.05). Conclusions:The risk of mother and child increases and the rate of cesarean section is high in older mothers. It is advocated to give birth at the right age and to strengthen the supervision and management of the gestation period of the elderly maternal so as to ensure the safety of mother and child.