Abstract：
Necrotizing enterocolitis (NEC) is a major cause of neonatal morbidity and mortality in preterm neonates, yet its pathophysiology remains unclear. The aim of this study is to evaluate risk factors for NEC using an identical twin model. In this case-control study, all monochorionic twin pairs born in our center in 2002-2020 were retrospectively reviewed for NEC. Potential risk factors for NEC were studied. For within-pair comparison, outcomes were compared between affected and unaffected twins. Within-pair analyses showed that the twin with NEC had a lower birth weight compared to its unaffected co-twin (1100 (913-1364) vs. 1339 (1093-1755) grams). Median gestational age at birth and birth weight were lower in twin pairs in the NEC-group compared to the no-NEC group, 29.1 weeks (27.8-30.8) versus 33.6 (30.7-36.0) and 1221 g (1010-1488) versus 1865 (1356-2355) respectively. Twin pregnancies in the NEC-group were more often complicated by twin-to-twin transfusion syndrome compared to the no-NEC-group (70 % (14/20) vs. 49 % (472/962)), particularly when treated with amnioreduction. This unique population of identical twins confirms that preterm neonates with a relatively lower birth weight are more prone to develop NEC compared to their co-twin, regardless of other genetic, maternal and obstetrical factors.
摘要：
坏死性小肠结肠炎（NEC）是早产新生儿发病和死亡的主要原因，然而其病理生理学仍不清楚。这项研究的目的是使用同卵双胞胎模型评估NEC的风险因素。在这项病例对照研究中，我们对2002-2020年在我们中心出生的所有单绒毛膜双胎对进行了NEC回顾性分析.研究了NEC的潜在危险因素。对于对内比较，比较受影响和未受影响的双胞胎的结局.配对分析显示，与未受影响的双胞胎相比，NEC双胞胎的出生体重较低（1100（913-1364）与1339（1093-1755）克）。与非NEC组相比，NEC组的双胞胎对出生时的中位胎龄和出生体重较低，分别为29.1周（27.8-30.8）对33.6（30.7-36.0）和1221g（1010-1488）对1865（1356-2355）。与非NEC组相比，NEC组的双胎妊娠更常并发双胎输血综合征（70％（14/20）与49%（472/962），特别是当羊膜减少治疗。这种独特的同卵双胞胎群体证实，与同卵双胞胎相比，出生体重相对较低的早产儿更容易发生NEC，不管其他基因，产妇和产科因素。
