Twins

双胞胎
  • 文章类型: Journal Article
    目的:系统回顾有关单卵(MZ)和二卵(DZ)双胞胎之间睡眠磨牙症(SB)一致性的文献。
    方法:此系统评价的注册是在国际系统评价前瞻性注册(PROSPERO,不。CRD42021251751)。截至2022年7月,搜索了四个数据库,包括PubMed,Scopus,Embase,和WebofScience,以及谷歌学者和OpenGrey中的灰色文献。包括评估任何年龄和性别的MZ和DZ双胞胎中SB的观察性研究。对于偏差风险的评估,JoannaBriggs的检查表被利用了.通过建议分级评估来评估证据的确定性,发展,和评估(等级)系统。进行了汇总和亚组荟萃分析,以估计双胞胎之间SB的一致性(p<0.05)。
    结果:总计,确定了3,155条记录。在定性分析中,包括11项研究;其中,7例纳入荟萃分析.大多数文章表现出低偏倚风险(63.6%)。在总体一致性分析(OR=1.47;95%CI=1.07-2.02)和正一致性分析中,MZ双胞胎之间的SB一致性高于DZ双胞胎之间(OR=1.53;95%CI=1.29-1.81)。在亚组分析中,仅对于报告/自我报告的SB在总体一致性(OR=1.44;95%CI=1.07~1.95)和正一致性(OR=1.55;95%CI=1.28~1.88)方面的显著性仍然存在.在一般一致性分析中观察到证据的确定性低,而对于正一致性观察到中等确定性。
    结论:与DZ双胞胎相比,MZ双胞胎中SB的一致性更高,表明可能的遗传影响条件的发生。
    OBJECTIVE: To systematically review the literature regarding the concordance of sleep bruxism (SB) between monozygotic (MZ) and dizygotic (DZ) twins.
    METHODS: The registration for this systematic review was accomplished in the International Prospective Register of Systematic Reviews (PROSPERO, No. CRD42021251751). As of July 2022, four databases were searched, including PubMed, Scopus, Embase, and Web of Science, as well as the grey literature in Google Scholar and OpenGrey. Observational studies evaluating SB in MZ and DZ twins of any age and sex were included. For the evaluation of the risk of bias, the Joanna Briggs checklist was utilized. The certainty of evidence was assessed via the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Pooled and subgroup meta-analyses were performed to estimate concordance of SB ​​between twins (p < 0.05).
    RESULTS: In total, 3,155 records were identified. In the qualitative analysis, eleven studies were included; of these, seven were included in the meta-analysis. The majority of the articles exhibited a low risk of bias (63.6%). Greater SB concordance was observed between MZ twins than between DZ twins in the analysis of general concordance (OR = 1.47; 95% CI = 1.07-2.02) and also positive concordance (OR = 1.53; 95% CI = 1.29-1.81). Within the subgroup analyses, the significance of the findings remained only for the reported/self-reported SB regarding general concordance (OR = 1.44; 95% CI = 1.07-1.95) and positive concordance (OR = 1.55; 95% CI = 1.28-1.88). Low certainty of the evidence was observed for the general concordance analysis, while moderate certainty was observed for the positive concordance.
    CONCLUSIONS: There was a higher concordance of SB in MZ twins compared to DZ twins, indicating a possible genetic influence on the condition\'s occurrence.
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  • 文章类型: Journal Article
    目的:当前的荟萃分析旨在检查饮食摄入量的遗传度和家族相似性,包括双胞胎和基于家庭的研究中的能量和大量营养素。
    方法:在线文献数据库,包括PubMed,Scopus,和WebofScience进行了全面搜索,直到2023年才确定相关研究。家庭研究的遗传力指数为h2,双胞胎研究的遗传力指数为h2,A2和E2。使用三种加权方法计算遗传力饮食摄入量的平均值和SE。
    结果:本荟萃分析包括18篇论文,包括8篇关于家族人群的研究和12篇关于双胞胎人群的研究。双胞胎研究中饮食摄入量的遗传率(汇总估计的h2,A2和E2的范围为30-55%,14-42%,52-79%,分别)高于家庭研究(汇总估计h2的范围=16-39%)。在家庭研究中,各种营养素的最高和最低遗传力是观察到的脂肪(%Kcal)(H2范围:36-38%)和碳水化合物(H2范围:16-18%),分别。在双胞胎研究中,基于平均H2,各种营养素的最高和最低遗传力被报告为脂肪(%Kcal)(H2范围:49-55%)和蛋白质摄入量(H2范围:30-35%),分别。此外,基于A2的平均值,观察到碳水化合物的最高和最低遗传力(%Kcal)(A2范围:42-42%),和蛋白质(%Kcal)(A2范围:14-16%),分别。此外,在双胞胎研究中,E2的最高和最低平均值显示为饱和脂肪(E2范围:74-79%)和能量摄入量(E2范围:52-57%),分别。
    结论:我们的分析表明,环境因素和遗传因素在确定膳食摄入量的遗传力方面都有显著的贡献。此外,与家庭研究相比,我们观察到双胞胎的遗传率更高。
    OBJECTIVE: The current meta-analysis aimed to examine the heritability and familial resemblance of dietary intakes, including energy and macronutrients in both twin and family-based studies.
    METHODS: The online literature databases, including PubMed, Scopus, and Web of Science were searched comprehensively until 2023 to identify the relevant studies. The heritability index in family studies was h2 and the heritability indices for twin studies were h2, A2, and E2. Three weighted methods were used to calculate the mean and SE of heritability dietary intakes.
    RESULTS: Eighteen papers including 8 studies on familial population and 12 for twin population studies were included in the present meta-analysis. The heritability of dietary intakes in twin studies (range of pooled estimated h2, A2, and E2 was 30-55%, 14-42%, and 52-79%, respectively) was higher than family studies (range of pooled estimated h2 = 16-39%). In family studies, the highest and lowest heritability for various nutrients was observed for the fat (%Kcal) (h2 range:36-38%) and carbohydrate in g (h2 range:16-18%), respectively. In twin studies, based on mean h2, the highest and lowest heritability for various nutrients was reported for the fat (%Kcal) (h2 range:49-55%) and protein intake in g (h2 range:30-35%), respectively. Also, based on the mean of A2, the highest and lowest heritability was observed for carbohydrates (% Kcal) (A2 range:42-42%), and protein (% Kcal) (A2 range:14-16%), respectively. Furthermore, in twin studies, the highest and lowest mean of E2 was shown for saturated fats (E2 range:74-79%) and energy intake (E2 range:52-57%), respectively.
    CONCLUSIONS: Our analysis indicated that both environmental factors and genetics have noticeable contributions in determining the heritability of dietary intakes. Also, we observed higher heritability in twins compared to family studies.
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  • 文章类型: Review
    背景:双角子宫妊娠的处理尤其具有挑战性。双角子宫是一种罕见的现象,双角子宫中的双胎妊娠更为罕见。这些怀孕需要深入的诊断调查和跨学科护理。
    方法:我们报告了一名27岁的欧洲女性患者(gravidaI,para0)在胚胎移植后在双角双颈子宫的每个腔中同时怀孕。通过宫腔镜和腹腔镜检查证实了病情。在每个玉米的胚胎移植之前,已经进行了几次失败的体外受精(IVF)尝试。在妊娠12+6周和22+0周进行差异筛查的生理妊娠过程后,患者在27+2周时出现治疗抵抗收缩.最终导致主胎的自然分娩和第二个胎儿的自然分娩延迟。
    结论:世界范围内仅有16例双颈单颈子宫双胎妊娠报告,6例双颈子宫双胎妊娠报告。这种怀孕的主要风险是早产,宫内生长受限,表现异常和先兆子痫。在上述情况下,双胎妊娠的这些典型风险因素大大增强。
    结论:存在子宫畸形的双胎妊娠是罕见且难以处理的。必须收集和报告这些罕见病例,以便制定出监测和治疗的算法,并为其管理提出适当的建议。
    BACKGROUND: The management of a pregnancy in a bicornuate uterus is particularly challenging. A bicornuate uterus is a rare occurrence and a twin pregnancy in a bicornuate uterus even more rare. These pregnancies call for intensive diagnostic investigation and interdisciplinary care.
    METHODS: We report on a 27-year-old European woman patient (gravida I, para 0) with a simultaneous pregnancy in each cavity of a bicornuate bicollis uterus after embryo transfer. The condition was confirmed by hysteroscopy and laparoscopy. Several unsuccessful in vitro fertilization (IVF) attempts had been performed earlier before embryo transfer in each cornus. After a physiological course of pregnancy with differential screening at 12 + 6 weeks and 22 + 0 weeks of gestation, the patient presented with therapy-resistant contractions at 27 + 2 weeks. This culminated in the uncomplicated spontaneous delivery of the leading fetus and delayed spontaneous delivery of the second fetus.
    CONCLUSIONS: Only 16 cases of twin pregnancy in a bicornuate unicollis uterus have been reported worldwide and only 6 in a bicornuate bicollis uterus. The principal risks in such pregnancies are preterm labor, intrauterine growth restriction, malpresentation and preeclampsia. These typical risk factors of a twin pregnancy are greatly potentiated in the above mentioned setting.
    CONCLUSIONS: A twin pregnancy in the presence of a uterine malformation is rare and difficult to manage. These rare cases must be collected and reported in order to work out algorithms of monitoring and therapy as well as issue appropriate recommendations for their management.
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  • 文章类型: Journal Article
    当前的研究是出于对加深对巴西双胞胎研究的理解的兴趣,在国际上代表性不足,为了纠正这种情况。我们的目标是三个方面:(1)根据知识领域对巴西的双胞胎研究进行全面调查;(2)与其他领域相比,评估心理学领域研究的代表性;(3)评估可能导致其被排除在50年双胞胎研究的综合荟萃分析之外的研究特征。根据PRISMA指南进行范围审查。直到2022年,标题和摘要在六个数据库中进行了搜索:CAPES,BDLTD,PePSIC,PubMed,谷歌学者,还有SciELO,使用选定的葡萄牙语和英语关键字(例如,\'双胞胎\'和\'巴西\';\'孪生\'和\'巴西\';\'gemelaridade\'[孪生],and\''gämeos\'[twins]).审查中包括340种出版物。大约一半(53.8‰)使用经典的双生设计来研究几个性状的遗传力,另一半(46.2%)使用其他研究设计。范围审查显示,出版物的数量大约每10年翻一番。大多数出版物来自卫生领域,医学大约占研究的一半,其次是心理学,牙本质学,和生物学。我们发现,多年来,巴西科学家对研究双胞胎的兴趣正在增加,并且有理由对这一趋势在全球情景中的潜在影响充满热情。
    The current study was motivated by an interest in deepening understanding of Brazilian twin research, which is underrepresented internationally, in an effort to rectify this situation. Our aim was threefold: (1) to carry out a comprehensive investigation of Brazilian research on twins according to the area of knowledge; (2) to evaluate the representation of research in the field of psychology in comparison with other areas; (3) to evaluate characteristics of the research that may have contributed to its exclusion from the comprehensive meta-analysis of 50 years of twin research. A scoping review was performed according to PRISMA guidelines. Titles and abstracts were searched up to 2022 in six databases: CAPES, BDLTD, PePSIC, PubMed, Google Scholar, and SciELO, using selected keywords both in Portuguese and in English (e.g., \'twins\' and \'Brazil\'; \'twinning\' and \'Brazil\'; \'gemelaridade\' [twinning], and \'gêmeos\' [twins]). Three hundred and forty publications were included in the review. Approximately half (53.8‰) used the classic twin design to investigate the heritability of several traits, and the other half (46.2%) used other research designs. The scoping review showed that the number of publications doubled approximately every 10 years. Most publications were from the health area, with medicine accounting for approximately half of the studies, followed by psychology, odontology, and biology. We found that the interest in studying twins among Brazilian scientists is increasing over the years and there are reasons to be enthusiastic about the potential impact of this trend in the global scenario.
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  • 文章类型: Journal Article
    背景:ART与双胎妊娠的发生率高于单胎妊娠。与非ART双胎妊娠相比,ART后怀孕的双胎妊娠是否有额外的母体和新生儿并发症尚不清楚。
    目的:目的是量化ART后受孕的双胎妊娠与非ART和自然受孕的母儿和围产期不良结局的风险。现有的审查在报告的结果方面有所不同,许多研究包括研究人群中的三胎妊娠。因此,我们的目的是进行一项最新的回顾,对限于双胎妊娠的孕产妇和围产期结局进行深入分析.
    方法:我们搜索了1990年1月至2023年5月的电子数据库MEDLINE和EMBASE,没有语言限制。所有队列研究均报告了ART后与非ART双胎妊娠和自然受孕相比的孕产妇和围产期结局。病例对照研究,病例报告,案例系列,动物研究,和体外研究被排除。纽卡斯尔-渥太华量表用于评估研究的方法学质量。使用随机效应荟萃分析,将估计值汇总,并将结果报告为比值比(OR),95%CI.
    结果:我们纳入了111项研究(802.462妊娠)。ART后的双胎妊娠在<34周时早产的风险较高(OR1.33,95%CI1.14-1.56,29项研究,I2=73%),<37周(OR1.26,95%CI1.19-1.33,70项研究,I2=76%),妊娠期高血压疾病(OR1.29,95%CI1.14-1.46,59项研究,I2=87%),妊娠期糖尿病(OR1.61,95%CI1.48-1.75,51项研究,I2=65%),和剖腹产(OR1.80,95%CI1.65-1.97,70项研究,I2=89%)与非ART双胞胎相比。与自然受孕相比,ART组中上述产妇结局的风险也增加。在围产期结局中,ART双胞胎的先天性畸形风险显着增加(OR1.17,95%CI1.05-1.30,39项研究,I2=59%),出生体重不一致(>25%(OR1.31,95%CI1.05-1.63,7项研究,I2=0%)),呼吸窘迫综合征(OR1.32,95%CI1.09-1.60,16项研究,I2=61%),和新生儿重症监护病房入院(OR1.24,95%CI1.14-1.35,32项研究,I2=87%)与非ART双胞胎相比。当将ART与自然概念进行比较时,呼吸窘迫综合征的风险,重症监护入院,出生体重不一致>25%在ART组中较高。围产期并发症,例如死产(OR0.83,95%CI0.70-0.99,33项研究,I2=49%),小于胎龄<10个百分位数(OR0.90,95%CI0.85-0.95,26项研究,I2=36%),和双胎-双胎输血综合征(OR0.45,95%CI0.25-0.82,9项研究,I2=25%),与未接受ART的双胎妊娠相比,接受ART的双胎妊娠减少。在ART组中,上述围产期并发症也比自然受孕少。
    结论:ART双胎妊娠与非ART妊娠和自然受孕相比,母体并发症较高,围产期结局各不相同。寻求ART的妇女应被告知ART双胎妊娠的风险增加,并应在怀孕期间密切监测并发症。由于研究的局限性,我们建议在解释研究结果时谨慎行事。
    BACKGROUND: ART is associated with higher rates of twin pregnancies than singleton pregnancies. Whether twin pregnancies conceived following ART have additional maternal and neonatal complications compared with non-ART twin pregnancies is not known.
    OBJECTIVE: The objective was to quantify the risk of adverse maternal and perinatal outcomes among twin pregnancies conceived following ART compared with non-ART and natural conception. Existing reviews vary in the reported outcomes, with many studies including triplet pregnancies in the study population. Therefore, we aimed to perform an up-to-date review with an in-depth analysis of maternal and perinatal outcomes limited to twin pregnancies.
    METHODS: We searched electronic databases MEDLINE and EMBASE from January 1990 to May 2023 without language restrictions. All cohort studies reporting maternal and perinatal outcomes following ART compared with non-ART twin pregnancies and natural conception were included. Case-control studies, case reports, case series, animal studies, and in vitro studies were excluded. The Newcastle-Ottawa Scale was used to assess the methodological quality of the studies. Using random-effects meta-analysis, the estimates were pooled and the findings were reported as odds ratios (OR) with 95% CI.
    RESULTS: We included 111 studies (802 462 pregnancies). Twin pregnancies conceived following ART were at higher risk of preterm birth at <34 weeks (OR 1.33, 95% CI 1.14-1.56, 29 studies, I2 = 73%), <37 weeks (OR 1.26, 95% CI 1.19-1.33, 70 studies, I2 = 76%), hypertensive disorders in pregnancy (OR 1.29, 95% CI 1.14-1.46, 59 studies, I2 = 87%), gestational diabetes mellitus (OR 1.61, 95% CI 1.48-1.75, 51 studies, I2 = 65%), and caesarean delivery (OR 1.80, 95% CI 1.65-1.97, 70 studies, I2 = 89%) compared with non-ART twins. The risks for the above maternal outcomes were also increased in the ART group compared with natural conception. Of the perinatal outcomes, ART twins were at significantly increased risk of congenital malformations (OR 1.17, 95% CI 1.05-1.30, 39 studies, I2 = 59%), birthweight discordance (>25% (OR 1.31, 95% CI 1.05-1.63, 7 studies, I2 = 0%)), respiratory distress syndrome (OR 1.32, 95% CI 1.09-1.60, 16 studies, I2 = 61%), and neonatal intensive care unit admission (OR 1.24, 95% CI 1.14-1.35, 32 studies, I2 = 87%) compared with non-ART twins. When comparing ART with natural conception, the risk of respiratory distress syndrome, intensive care admissions, and birthweight discordance >25% was higher among the ART group. Perinatal complications, such as stillbirth (OR 0.83, 95% CI 0.70-0.99, 33 studies, I2 = 49%), small for gestational age <10th centile (OR 0.90, 95% CI 0.85-0.95, 26 studies, I2 = 36%), and twin-twin transfusion syndrome (OR 0.45, 95% CI 0.25-0.82, 9 studies, I2 = 25%), were reduced in twin pregnancies conceived with ART versus those without ART. The above perinatal complications were also fewer amongst the ART group than natural conception.
    CONCLUSIONS: ART twin pregnancies are associated with higher maternal complications than non-ART pregnancies and natural conception, with varied perinatal outcomes. Women seeking ART should be counselled about the increased risks of ART twin pregnancies and should be closely monitored in pregnancy for complications. We recommend exercising caution when interpreting the study findings owing to the study\'s limitations.
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  • 文章类型: Systematic Review
    学习阅读是一个动态和累积的过程,从出生开始,一直持续到学年。经验数据显示,从学龄前到中学,加性遗传(A)和共享环境(C)成分减少,非共享环境(E)成分增加。然而,我们对这一发展时期阅读技能的连续性和变化的病因的理解是有限的。按照PRISMA准则,我们回顾了从学龄前/幼儿园到初中/高中的13项纵向双胞胎和过继兄弟姐妹研究对阅读相关神经认知技能的行为遗传学研究结果.我们的研究结果表明,在整个研究期间,连续性主要由A成分解释,and,尽管在较小程度和较不一致的情况下,早期的C组件;这些年来,新的E组件解释了变化,以及早期新的A组件。由于我们对与发育过程中早期发作的特征相关的模型感兴趣,深入研究发育时间如何调节遗传和环境变异至关重要。
    Learning to read is a dynamic and cumulative process beginning from birth and continuing through the school years. Empirical data showed a decrease of additive genetic (A) and shared environmental (C) components and an increase of non-shared environmental (E) components from preschool to middle school. However, our understanding of the aetiology of continuity and change of reading skills across this developmental period is limited. Following the PRISMA guidelines, we reviewed the results of behavioral genetic research on reading-related neurocognitive skills of 13 longitudinal twin and adoptive sibling studies spanning from preschool/kindergarten to middle/high school. Our findings suggested that continuity was mainly explained by A components throughout the study periods, and, although to a lesser extent and less consistently, by C components during the early years; change was explained by new E components throughout the years, and also by new A components in the early years. As we are interested in models relevant to traits with early onset during development, it is crucial to deepen the investigation of how developmental time can moderate the genetic and environmental variation.
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  • 文章类型: Systematic Review
    目的:与单胎相比,双胎妊娠早产(PTB)的风险增加。宫颈长度(CL)的评估代表了筛选单例PTB的最佳工具。相反,在双胞胎中使用CL的证据较少。我们的目的是使用AGREEII方法评估双胞胎中CL应用的临床实践指南(CPG)的方法学质量和临床异质性。
    方法:MEDLINE,Scopus,并审查了主要科学学会的网站。对以下方面进行了评估:CL的诊断准确性,CL降低的双胎妊娠评估和干预措施时的最佳胎龄。已发布的CPG的质量是使用“重新搜索和评估指南评估(AGREEII)”工具进行的。使用评分系统对指南的质量进行评级。审稿人以7分制对每个考虑的项目进行评估,范围从1(强烈不同意)到7(强烈同意)。>60%的截止值将CPG识别为推荐的。
    结果:第一次总体评估的AGREEII标准化领域得分的平均值为74%。在分析的66.6%的CPG中,得分超过60%,这表明审阅者之间就推荐使用这些CPG达成了协议。发现了显着的异质性;在大约一半的已发表的CPG中,没有关于CL评估的具体建议。CL截止值也存在显著异质性以提示干预。
    结论:尽管AGREEII分析表明所纳入的大多数指南质量良好,作为适应症,CPG之间存在显著的异质性,定时,以及双胞胎中CL的截止以及干预措施的指示。
    OBJECTIVE: Twin pregnancies are at increased risk of preterm birth (PTB) compared to singletons. Evaluation of cervical length (CL) represents the optimal tool to screen PTB in singleton. Conversely, there is less evidence on the use of CL in twins. Our aim was to evaluate the methodological quality and clinical heterogeneity of clinical practice guidelines (CPGs) on the CL application in twins using AGREE II methodology.
    METHODS: MEDLINE, Scopus, and websites of the main scientific societies were examined. The following aspects were evaluated: diagnostic accuracy of CL, optimal gestational age at assessment and interventions in twin pregnancies with reduced CL. The quality of the published CPGs was carried out using \"The Appraisal of Guidelines for REsearch and Evaluation (AGREE II)\" tool. The quality of guideline was rated using a scoring system. Each considered item was evaluated by the reviewers on a seven-point scale that ranges from 1 (strongly disagree) to 7 (strongly agree). A cut-off >60 % identifies a CPGs as recommended.
    RESULTS: The AGREE II standardized domain scores for the first overall assessment had a mean of 74 %. The score was more than 60 % in the 66.6 % of CPGs analyzed indicating an agreement between the reviewers on recommending the use of these CPGs. A significant heterogeneity was found; there was no specific recommendation on CL assessment in about half of the published CPGs. There was also significant heterogeneity on the CL cut-off to prompt intervention.
    CONCLUSIONS: Despite the fact that the AGREE II analysis showed that the majority of the included guidelines are of good quality, there was a significant heterogeneity among CPGs as regard as the indication, timing, and cut-off of CL in twins as well as in the indication of interventions.
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  • 文章类型: Meta-Analysis
    背景:妊娠32周前出生的双胞胎的分娩方式仍存在争议。我们的目的是对小于32周的双胎妊娠或小于1500g的双胎妊娠进行荟萃分析,从而找到合适的送货方式。
    方法:我们搜索了PubMed数据库,Cochrane图书馆数据库,和EMBASE数据库到2022年12月。该方案在启动前注册到PROSPERO(CRD42023386946)。包括对妊娠少于32周或出生体重低于1500g的新生儿进行阴道分娩与剖宫产的研究。主要结果是新生儿死亡率。次要结果是新生儿发病率。按照纽卡斯尔-渥太华量表(NOS)文献质量评价量表对纳入研究的文献质量进行评价。我们使用比值比(OR)作为二元变量的效果指数。计算点估计和95%置信区间(95%CI)。P<0。05表示有统计学差别。
    结果:我们的搜索生成了5310篇文章,共8篇文章,共14,703名新生儿纳入分析。与剖宫产相比,阴道分娩的双胞胎新生儿死亡率的比值比为0.84(95%CI0.57-1.24,P=0.38)。5分钟Apgar评分<7(95%CI0.44-1.75,P=0.72),坏死性小肠结肠炎(95%CI0.81-1.19,P=0.82),脑室内出血(95%CI0.41-1.86,P=0.71),脑室周围白质软化(95%CI0.16-4.52,P=0.84),支气管肺发育不良(95%CI0.88-1.36,P=0.42),和呼吸窘迫综合征(95%CI0.23~2.01,P=0.48)在两组间无统计学意义。
    结论:我们观察到,在妊娠32周前出生的双胞胎中,阴道分娩不会增加新生儿发病和死亡的风险。然而,目前的结果受到实质性异质性和混杂因素的影响。我们仍然需要高质量的随机对照研究来解决这个重要问题。
    BACKGROUND: The mode of delivery for twins born before 32 weeks of gestation remains controversial. Our purpose is to conduct a meta-analysis of twin pregnancies less than 32 weeks or twin weight less than 1500 g, so as to find a suitable delivery mode.
    METHODS: We searched PubMed database, Cochrane Library database, and EMBASE database through December 2022. This protocol was registered with PROSPERO (CRD42023386946) prior to initiation. Studies that compared vaginal delivery to cesarean section for newborns less than 32 weeks of gestation or birthweight under 1500 g were included. The primary result was neonatal mortality rate. Secondary result was neonatal morbidity. The quality of literatures included in the research was evaluated in accordance with Newcastle-Ottawa Scale (NOS) literature quality evaluation scale. We use odds ratio (OR) as the effect index for binary variables. Point estimates and 95% confidence intervals (95% CI) were calculated. P < 0. 05 indicated statistically significant difference.
    RESULTS: Our search generated 5310 articles, and a total of 8 articles comprising a total of 14,703 newborns were included in the analysis. The odds ratios of neonatal mortality rate were for twins delivered by vaginal delivery compared to cesarean section were 0.84 (95% CI 0.57-1.24, P = 0.38). The 5-min Apgar score < 7 (95% CI 0.44-1.75, P = 0.72), necrotizing enterocolitis (95% CI 0.81-1.19, P = 0.82), intraventricular hemorrhage (95% CI 0.41-1.86, P = 0.71), periventricular leukomalacia (95% CI 0.16-4.52, P = 0.84), bronchopulmonary dysplasia (95% CI 0.88-1.36, P = 0.42), and respiratory distress syndrome (95% CI 0.23-2.01, P = 0.48) were not statistically significant between the two groups.
    CONCLUSIONS: We have observed that vaginal delivery does not confer an increased risk of neonatal morbidity and mortality in twins born before 32 weeks of gestation. However, the current results are affected by substantial heterogeneity and confounding factors. We still need high-quality randomized-controlled studies require to address this important question.
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  • 文章类型: Journal Article
    目的:在从受孕到两岁的前1001天内支持家庭对于设定情感至关重要,认知,以及儿童未来的物理积木。有双胞胎的家庭,三胞胎,或更高阶的倍数(多胎家庭)由于同时照顾一个以上的婴儿而面临独特的挑战。因此,确定多胎家庭的需求对于在头1001个关键天提供最佳支持是必要的。
    方法:进行了快速审查,以综合了解英国(UK)在前1001个关键天的多胎家庭的需求。来自五个数据库的调查结果(MEDLINE,APAPsycarticles,APAPsycInfo,CINAHL,和WebofScience)的同行评审研究和2012年至2022年之间发表的灰色文献进行了合成。使用叙事综合对15项研究进行了综述。
    结果:多胎家庭在最初1001个关键的日子里有独特而复杂的情感和实际需求,特别是,出生后的第一年,复杂的怀孕和早产进一步影响。在四个关键主题中确定了需求:高风险怀孕和分娩;提高倍数的现实转变;支持不足;并对经验产生积极影响。卫生专业人员的支持不一致,特别是在产时缺乏,产后,包括过渡在内的社区护理。
    结论:在头1001天的护理设计和交付中,应考虑多胎家庭的需求,尤其是出生后的第一年。需要在前1001个关键天多次提供具体建议,对卫生专业人员进行培训,以适应该人群的普遍建议是实现这一目标的一种方法。需要进一步的研究,以确保这一建议是基于证据和有效的。
    OBJECTIVE: Supporting families during the first 1001 days from conception to the age of two is vital for setting the emotional, cognitive, and physical building blocks for children\'s futures. Families with twins, triplets, or higher order multiples (multiple birth families) have unique challenges due to caring for more than one baby at the same time. Therefore, identifying the needs of multiple birth families is necessary to provide optimum support during the first 1001 critical days.
    METHODS: A rapid review was undertaken to synthesize knowledge of the needs of multiple birth families in the United Kingdom (UK) during the first 1001 critical days. Findings from five databases (MEDLINE, APA PsycArticles, APA PsycInfo, CINAHL, and Web of Science) for peer-reviewed studies and grey literature published between 2012 and 2022 were synthesized. Fifteen studies were reviewed using narrative synthesis.
    RESULTS: Multiple birth families have unique and complex emotional and practical needs across the first 1001 critical days, and in particular, the first-year post birth, impacted further by complicated pregnancies and prematurity. Needs were identified within the four key themes: high risk pregnancy and birth; transformed reality of raising multiples; inadequate support; and positively affecting experiences. Health professional support was inconsistent and particularly lacking in intrapartum, postnatal, and community care including transition.
    CONCLUSIONS: Multiple birth families\' needs should be considered in the design and delivery of care within the first 1001 critical days, especially within the first year after birth. Multiples specific advice across the first 1001 critical days is needed and training for health professionals to adapt universal advice for this population is one way to achieve this. Further research is needed to ensure this advice is evidence based and effective.
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  • 文章类型: Meta-Analysis
    目的:牙槽细胞特征的遗传基础已通过多项研究进行了研究,然而,调查结果是模棱两可的。这项系统评价和荟萃分析的目的是评估人类牙列不同阶段牙弓和咬合参数的遗传性。
    方法:电子数据库PubMed,Embase,Scopus,WebofScience,直到2023年8月,在没有语言或出版日期限制的情况下,搜索了牙科和口腔科学来源。
    方法:本综述包括调查双胞胎和兄弟姐妹牙槽参数遗传度的实证研究。
    方法:研究选择,数据提取,和偏倚风险评估由两名作者独立且一式两份进行,如果需要,第三作者解决了冲突.JoannaBriggs研究所的关键评估工具用于评估研究中的偏倚风险,并使用建议分级评估证据的确定性,评估,发展,和评估(等级)标准。
    结果:28项研究纳入系统评价,其中15项报告恒牙阶段遗传力系数的研究被认为适用于荟萃分析。随机效应荟萃分析显示上颌磨牙间宽度的高遗传度估计值(0.52),上颌齿间宽度(0.54),下颌磨牙间宽度(0.55),下颌间宽度(0.55),上颌弓长度(0.76),下颌弓长(0.57),和腭深(0.56)。咬合参数的遗传力估计差异很大,交叉咬合(0.46)和过咬合(0.44)的值相对适中,颊段关系的值较低(0.32),喷射机(0.22),和旋转和位移的牙齿(0.16)。然而,根据GRADE标准,大多数结局的证据确定性较低.
    结论:根据现有证据,可以得出结论,牙弓尺寸具有较高的遗传力,而咬合参数显示中等至较低的遗传力。
    背景:PROSPERO(CRD42022358442)。
    The genetic basis of dentoalveolar characteristics has been investigated by several studies, however, the findings are equivocal. The objective of this systematic review and meta-analysis was to evaluate the heritability of dental arches and occlusal parameters in different stages of human dentition.
    Electronic databases PubMed, Embase, Scopus, Web of Science, and Dentistry and Oral Science Source were searched up to August 2023 without the restriction of language or publication date.
    Empirical studies investigating the heritability of dentoalveolar parameters among twins and siblings were included in the review.
    Study selection, data extraction, and risk of bias assessment were performed independently and in duplicate by two authors and a third author resolved conflicts if needed. Joanna Briggs Institute\'s critical appraisal tool was used to evaluate the risk of bias among studies and the certainty of evidence was assessed using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria.
    Twenty-eight studies were included in the systematic review, of which 15 studies reporting heritability coefficients in the permanent dentition stages were deemed suitable for the meta-analysis. Random-effects meta-analyses showed high heritability estimates for maxillary intermolar width (0.52), maxillary intercanine width (0.54), mandibular intermolar width (0.55), mandibular intercanine width (0.55), maxillary arch length (0.76), mandibular arch length (0.57), and palatal depth (0.56). The heritability estimates for the occlusal parameters varied considerably, with relatively moderate values for crossbite (0.46) and overbite (0.44) and low values for buccal segment relationship (0.32), overjet (0.22), and rotation and displacement of teeth (0.16). However, the certainty of evidence for most of the outcomes was low according to the GRADE criteria.
    Based on the available evidence, it can be concluded that the dental arch dimensions have a high heritability while the occlusal parameters demonstrate a moderate to low heritability.
    PROSPERO (CRD42022358442).
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