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DOI: 10.1055/s-2007-989482
© Georg Thieme Verlag KG Stuttgart · New York
Aufnahmegründe und Aufenthaltsdauer von Zwillingen und Drillingen im Neonatologiezentrum in Abhängigkeit vom Konzeptionsmodus
Neonatal Characteristics of Twins and Triplets Admitted to the Neonatal Intensive Care Unit Depending on the Mode of ConceptionPublication History
eingereicht 4.9.2007
revidiert 12.11.2007
akzeptiert 5.12.2007
Publication Date:
26 February 2008 (online)
![](https://www.thieme-connect.de/media/gebfra/200802/lookinside/thumbnails/10.1055-s-2007-989482-1.jpg)
Zusammenfassung
Fragestellung: Die Zunahme von Mehrlingsschwangerschaften betrifft durch maternale und fetale Komplikationen gleicherseits Geburtshelfer und Pädiater. Häufig kommt es zu einem postpartalen Transfer der Mehrlinge in ein Neonatologiezentrum (NNZ). Ziel der vorliegenden Studie ist es zu klären, ob Unterschiede für einen Transfer bzw. in der Aufenthaltsdauer abhängig vom Konzeptionsmodus bestehen. Material und Methoden: Bei insgesamt 996 Mehrlingsgeborenen in der Universitätsklinik für Frauenheilkunde und Geburtshilfe Salzburg, Österreich, im Zeitraum Januar 1996 bis Dezember 2005 war bei 624 Kindern der Konzeptionsmodus bekannt. In die Studie wurden die 253 postpartal in das NNZ transferierten Zwillinge und Drillinge eingeschlossen. Die Untersuchungsgruppe setzte sich aus 66 assistiert konzipierten Zwillingen (B) und 41 assistiert konzipierten Drillingen (C) zusammen. Die Kontrollgruppe bestand aus 146 spontan konzipierten Zwillingen (A). Ergebnisse: Gestationsalter (GA) und stationäre Aufenthaltsdauer sowie die perinatalen Parameter Apgar-Werte, Blutgasanalyse und Geburtsmaße waren ident. Die Prävalenz diverser Morbiditäten und Fehlbildungen zeigte bis auf das bei Drillingen (58,5 %) häufiger als bei spontan konzipierten Zwillingen (37,0 %) auftretende Atemnotsyndrom keine Signifikanz. Die Häufigkeit einer druckkontrollierten Beatmung war in allen Gruppen ident; allein die Dauer war bei Zwillingen aus assistierter Konzeption (6,0 ± 5,0, Tage ± SD) kürzer als in den anderen beiden Gruppen (A: 12,0 ± 10,3 und C: 12,1 ± 5,8). Mit zunehmendem Lebensalter war ein Abnehmen der Mortalität zu erkennen. Die Mütter in der Untersuchungsgruppe (32,5 ± 4,5, Jahre ± SD) waren älter als in der Kontrollgruppe (29,7 ± 5,2), sie zeigten die Tendenz zu einer Kaiserschnittentbindung. Schlussfolgerung: Assistiert konzipierte Mehrlinge wiesen mit Ausnahme der respiratorischen Parameter ein vergleichbares perinatales Outcome zu spontan konzipierten Mehrlingen auf.
Abstract
Purpose: The increasing prevalence of multiple pregnancies is a matter of concern both for obstetricians and pediatricians as it results in a higher transfer rate to neonatal intensive care units (NICU). The object of this study was to analyze the reasons for NICU transfer and the length of stay, and correlate this with the mode of conception. Material and Methods: Out of a total of 996 multiples delivered at the Department of Obstetrics and Gynecology in Salzburg, Austria from January 1996 until December 2005, the mode of conception was known for 624 multiples. The 253 neonates transferred to the NICU were included in the study for analysis. The transferred study group comprised 66 assisted conceived twins (B) and 41 assisted conceived triplets (C). The control group (A) comprised 146 spontaneously conceived twins. Results: All multiples showed comparable gestational ages at birth and durations of stay in the NICU. There were no differences in the perinatal parameters “Apgar score” and “cord blood gases” as well as birth weight and length. The prevalence of various morbidities and malformations was comparable between groups with the exception of respiratory distress syndrome, which was more frequent in triplets (58.5 %) than in spontaneously conceived twins (37.0 %). Furthermore, the incidence of artificial respiration was comparable between groups. Only the duration of pressure-controlled respiration of twins conceived by ART (6.0 ± 5.0 days ± SD) was significantly shorter compared to both other groups (A: 12.0 ± 10.3 and C: 12.1 ± 5.8). The mothers of the babies of the test groups (32.5 ± 4.5 years ± SD) were older than those in the control group (29.7 ± 5.2) and showed a tendency towards cesarean delivery. Conclusions: With the exception of respiratory parameters, assisted conceived multiples had comparable perinatal outcomes to those who were conceived spontaneously.
Schlüsselwörter
assistierte Reproduktion - Risikoschwangerschaft - Zwillinge/Drillinge - Neonatologiezentrum (NNZ)
Key words
assisted reproduction technique (ART) - high‐risk pregnancy - twins/triplets - neonatal intensive care unit (NICU)
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Univ.-Doz. Dr. Horst Steiner
Univ.-Klinik für Frauenheilkunde und Geburtshilfe
Müllner Hauptstraße 48
5020 Salzburg
Österreich
Email: h.steiner@salk.at