■胎儿生长受限(FGR)会对肺发育产生负面影响,在以后的生活中导致呼吸道发病率增加和肺功能降低。关于FGR对单胎肺功能影响的研究受遗传影响,产科,和母性因素。为了克服这些混杂因素,我们的目的是调查选择性FGR(sFGR)的同卵双胞胎的肺功能。
对2002年3月1日至2017年12月31日出生在我们中心的sFGR同卵双胞胎进行肺功能评估,年龄在5岁至17岁之间。sFGR定义为出生体重不一致≥20%。结果测量包括1s内用力呼气量(FEV1),强迫肺活量(FVC),和一氧化碳(DLCO)的转移因子,并在较小和较大的双胞胎之间进行了比较。
■39对双胞胎进行了足够质量的肺活量测定。出生时的中位胎龄为34.3周(四分位数间距(IQR)32.1-36.0周),较小和较大的双胞胎的中位出生体重为1500(IQR1160-1880)克和2178(IQR1675-2720)克,分别。较小的双胞胎FEV1的z得分明显较低(-0.94对-0.41,p=0.0015),与较大的共孪晶相比,FVC(-0.56对-0.06,p<0.0001)和DLCO(-0.50对0.00,p<0.0001)。
■虽然基因相同,同卵双生子sFGR与静态和动态肺容量减少以及肺弥散减少有关,即使考虑到肺容量的减少。这表明子宫内不利的生长状况会对肺发育和功能产生负面影响。在以后的生活中可能导致呼吸道疾病的增加。
■荷兰心脏基金会和Bontius基金会。
UNASSIGNED: Fetal growth restriction (FGR) can negatively affect lung development, leading to increased respiratory morbidity and reduced lung function later in life. Studies regarding the impact of FGR on lung function in singletons are influenced by genetic, obstetric, and maternal factors. To overcome these confounding factors, we aim to investigate lung function in identical twins with selective FGR (sFGR).
UNASSIGNED: Lung function assessments were performed in identical twins with sFGR born in our centre between March 1, 2002, and December 31, 2017, aged between 5 and 17 years. sFGR was defined as birthweight discordance ≥20%. Outcome measures consisted of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and transfer factor for carbon monoxide (DLCO) and were compared between the smaller and larger twin.
UNASSIGNED: Thirty-nine twin pairs performed spirometry of sufficient quality. Median gestational age at birth was 34.3 (interquartile range (IQR) 32.1-36.0) weeks with median birthweights of 1500 (IQR 1160-1880) grams and 2178 (IQR 1675-2720) grams for the smaller and larger twin, respectively. Smaller twins had significantly lower z-scores for FEV1 (-0.94 versus -0.41, p = 0.0015), FVC (-0.56 versus -0.06, p < 0.0001) and DLCO (-0.50 versus 0.00, p < 0.0001) compared to larger co-twins.
UNASSIGNED: Although being genetically identical, sFGR in identical twins is associated with a reduction in static and dynamic lung volume and a reduction in lung diffusion, even when taking the reduced lung volume into account. This indicates that adverse growth conditions in utero negatively affect lung development and function, potentially contributing to an increase in respiratory morbidities later in life.
UNASSIGNED: The Dutch Heart Foundation and The Bontius Foundation.