융모막성에 따른 쌍태아 체중 불일치의 주산기 예후 = Perinatal outcomes of birth weight discordance according to the chorionicity

국문 초록 (Abstract)

목적: 본 연구는 융모막성에 따라 쌍태아간 체중불일치와 주산기 예후와의 관련성을 알아보고자 하였다. 방법: 2000~2007년 동안 가톨릭대학교 성빈센트병원에서 분만한 쌍태아를 대상으로 후향적 연구를 시행하였다. 체중불일치는 체중이 큰 신생아를 기준으로 20% 이상 차이가 있는 경우이며 체중일치는 20% 이하의 차이가 있는 경우로 정의하여 단일융 모막성 및 이중융모막성 쌍태아에서 체중불일치군과 체중일치군 간의 주산기 결과를 비교 분석하였다. 결과: 38명의 단일융모막성 쌍태아에서 34.2%는 체중불일치였고 66.8%는 체중일치를 보였으며 144명의 이중융모막성 쌍태아에서 9.9%의 체중불일치와 91.9%의 체중일치를 보였다. 단일융모막성 쌍태아의 체중불일치군과 체중일치군을 비교한 결과 자궁내태아사망, 쌍태아간 수혈증후군, 자궁내발육저하 및 신생아 저혈당증의 발생이 통계학적으로 유의하게 증가하였으며 이중융모막성 쌍태아에서는 자궁내발육저하와 저혈당증의 발생이 체중불일치군에서 증가하였다. 기타 주산기 결과는 두 융모막성쌍태아의 각각 군간에 통계적으로 유의한 차이를 보이지 않았다. 결론: 단일융모막성 쌍태아의 체중불일치는 태아 사망, 쌍태아간수혈증후군, 자궁내태아발육부전 및 신생아 저혈당의 발생의 가능성이 높으며 이중융모막성 쌍태아의 체중 불일치는 자궁내태아발육부전 및 신생아 저혈당의 발생 가능성이 높지만, 불량한 주산기 결과를 단정적으로 예측하기에는 미흡한 요인이라고 생각된다.

다국어 초록 (Multilingual Abstract)

Objective: The purpose of this study was to examine the association between intrapair birth weight discordance and perinatal outcomes according to the chorionicity. Methods: Twin births in St. Vincent`s Hospital of Catholic University of Korea for the period 2000~2007 were retrospectively studied. Discordance was defined as an intertwin birth weight difference ≥20% and concordance was defined as weight difference <20% calculated from the larger newborn. Perinatal outcomes were compared between discordant and concordant pairs in monochorio-diamnionic and dichorionic twins. Results: Among 38 monochorionic twin births, 34.2% was discordant and 66.8% was concordant. Among 144 dichorionic twin birth, 9.9% was discordant and 91.9% was concordant. The incidences of intrauterine fetal death (FDIU), twin-to-twin transfusion syndrome (TTTS), intrauterine growth restriction (IUGR) and neonatal hypoglycemia of discordant group of monochorionic twins were statistically increased compared with concordant group of monochorionic twins. The incidences of IUGR and neonatal hypoglycemia were statistically increased in the discordant group of dichorionic twins compared with concordant group of dichorionic twins. The others were not shown statistically significant between two groups in the both chorionic twins. Conclusions: Birth weight discordance in monochorionicity seems to predict fetal death, TTTS, IUGR and newborn hypoglycemia. Birth weight discordance in dichorionicity does not seem to be good predictor of adverse perinatal outcomes except IUGR and neonatal hypoglycemia.

참고문헌 (Reference)

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