【摘要】 目的 探讨不同绒毛膜性对双胎妊娠结局的影响。方法 回顾性分析2020年1月至2021年9月在济宁医学院附属医院产科分娩的424例双胎妊娠孕产妇的临床资料，按绒毛膜性分为单绒毛膜双胎组(MC组，92例)和双绒毛膜双胎组(DC组，332例),分析比较其妊娠结局。结果 MC组的分娩孕周、新生儿出生体重、1 min Apgar评分及胚胎移植-体外受精(IVF-ET)的比例均低于DC组，差异有统计学意义(P<0.05);MC组早产、低出生体重儿(LBW)和入住新生儿监护病房(NICU)的比例高于DC组，胎膜早破(PROM)和小于胎龄儿(SGA)的比例低于DC组，差异有统计学意义(P<0.05),其余并发症两组间差异无统计学意义(P>0.05)。调整变量的单因素分析结果显示，MC组早产、LBW和入住NICU的发生风险高于DC组[OR(95%CI):7.0(3.2-15.4);1.5(1.0-2.1);1.9(1.1-3.3),P<0.05],而PROM的发生风险低于DC组[OR(95%CI):0.3(0.1-0.7),P<0.05],其余并发症的发生风险与绒毛膜性无关(P>0.05)。结论 双胎妊娠结局与绒毛膜性密切相关，单绒毛膜双胎增加了早产和新生儿并发症的风险性，因此，应加强单绒毛膜双胎的孕期管理，减少不良妊娠结局的发生。更多还原

【Abstract】 Objective To investigate the effect of different chorionicity ofpregnancy outcome in twin pregnancies. Methods Retrospective analysis of 424 twin pregnancies delivered in the hospital from January 2020 to September 2021, it divided into monochorionic twin group(MC group, 92 cases) and dichorionic twin group(DC group, 332 cases) according to chorionicity, to analyzed and compared the pregnancy outcomesin twin pregnancies. Results The week of delivery, neonatal birth weight, 1-minute Apgar score and the percentage of embryo transfer-in vitro fertilization(IVF-ET) were lower in MC group than in DC group, and the difference were statistically significant(P<0.05); the percentage of preterm delivery, low birth weight infants(LBW) and admission to neonatal care unit(NICU) were higher in MC group than in DC group, and the percentage of premature rupture of membranes(PROM) and small for gestational age(SGA)were lower than in DC group, with statistically significant differences(P<0.05), there were no significant differences in other complications between the two groups(P>0.05). Univariate analysis adjusting for variables showed that the risk of preterm delivery; LBW and NICU admission were higher in MC group than in DC group [OR(95% CI): 7.0(3.2-15.4); 1.5(1.0-2.1); 1.9(1.1-3.3), P<0.05], while the risk of PROM was lower than in the DC group [OR(95% CI): 0.3(0.1-0.7), P<0.05], and the risk of the remaining complications was not related to chorionicity(P>0.05). Conclusion Twin pregnancy outcomes are closely related to chorionicity, and monochorionic twins for increasing the risk of preterm delivery and neonatal complications.Therefore, pregnancy management of monochorionic twins should be enhanced to reduce the occurrence of adverse pregnancy outcomes.更多还原