Abstract:

Objective　To study the physical growth characteristics of birthweight discordant twins（BDT） under 4 years old. Methods　The physical growth characteristics of BDT under 4 years old born from September 2010 to December 2017 in child health care system of Children’s Hospital of Chongqing Medical University were analyzed retrospectively. R 3.5.3 was used to clean up the database，analyze the distribution of different degree of birthweight discordance，and draw the fitting curves.  More than 20% of birth weight difference was taken as inclusive criteria of BDT. BDT were divided into preterm or full-term groups，and low birthweight or normal birthweight groups respectively. SPSS 19.0 software was used for statistical analysis. Results　A total of 141 pairs of BDT were included，accounting for 15.4%（141/916）. The degree of birthweight difference in premature BDT was higher than that of full-term BDT（t＝3.820，P＜0.001）. The growth discordance of preterm BDT lasted longer. Physical growth of low/very low birthweight BDT was slower than that of normal birthweight BDT under 4 years old. The growth status of BDT didn’t reach the average level of WHO growth chart by the time of the last follow-up. Conclusion　Birthweight discordance of twins could have long-lasting effects on further growth and development. Preterm twins have higher degree of birthweight discordance，and the growth discordance lasts longer. Low birthweight is an important reason for growth retardation of the lighter BDT. Growth of BDT should be monitored regularly to increase follow-up compliance.

Key words: twins, birthweight discordance, preterm, physical growth

摘要：

目的　分析出生体重不一致双胎（birthweight discordant twins，BDT）0～4岁的体格指标，了解BDT出生体重以及BDT体格生长情况。方法　回顾性分析2010年9月至2017年12月重庆医科大学附属儿童医院儿童保健系统中出生体重不一致双胎（birthweight discordant twins，BDT）0～4岁的体格指标，运用R 3.5.3对数据库进行清理，以出生体重相差20%以上作为纳入标准，分析BDT的差异程度分布，同时对纳入的BDT儿童分别按早产和足月、正常出生体重和低/极低出生体重分组，绘制0～4岁体格指标拟合曲线，并分别与出生体重一致双胎、正常出生体重BDT的体格指标的拟合曲线以及WHO生长曲线（2006版）平均水平进行对比。出生体重差异程度比较及低/极低出生体重儿分布情况比较分析采用SPSS 19.0软件。结果　共纳入BDT 141对，占15.4%（141/916）。早产BDT出生体重差异程度高于足月BDT（t＝3.820，P＜0.001）。早产BDT差异持续时间更长。低/极低出生体重BDT 0～4岁体格生长水平较正常出生水平BDT落后。BDT末次随访时身高体重水平未达世界卫生组织（WHO）平均水平。结论　双胎出生体重的差异可能对其远期生长发育有持续性影响，早产BDT的出生体重差异更大，差异持续时间更长，低水平的出生体重是BDT中较轻者体格发育落后的重要原因。应定期监测BDT生长发育，提高随访依从性。

关键词: 双胎, 出生体重不一致, 早产, 体格生长