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Archives de pédiatrie : organe officiel de la Société française de pédiatrie v.24 no.12, 2017년, pp.1299 - 1311   SCIE
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About twins: Epidemiological, genetic, and obstetrical aspects, specific risks, and outcome
Le monde des jumeaux : aspects EpidEmiologiques et gEnEtiques, enjeux obstEtricaux, risques spEcifiques et devenir

Tauzin, M. (Service de cardiopédiatrie, hôpital universitaire Necker–Enfants-Malades, AP–HP, 149, rue de Sèvres, 75015 Paris, France ) ; Felix, A. (Service d'hémato-oncologie, hôpital universitaire Armand-Trousseau, AP–HP, 75012 Paris, France ) ; Michot, C. (Service de génétique médicale, hôpital universitaire Necker–Enfants-Malades, université ) ; Dedieu, C. (Paris-Descartes, AP–HP, 75015 Paris, France ) ; Aoust, L. (Universitätsklinikum Charité, Berlin, Allemagne ) ; Fortas, F. (Service de pneumopédiatrie, hôpital universitaire Necker–Enfants-Malades, AP–HP, 75015 Paris, France ) ; Guillier, C. (Service de néphropédiatrie, hôpital universitaire Armand-Trousseau, AP–HP, 75012 Paris, France ) ; Ngo, J. (Service de neuropédiatrie et maladies métaboliques, hôpital universitaire Robert-Debré, AP–HP, 75019 Paris, France ) ; Wachter, P.-Y. (Service d'oncopédiatrie, institut Curie, AP–HP, 75005 Paris ) ; Petermann, L. ; Kermorvant-Duchemin, E. ;
  • 초록  

    Summary The incidence of twin pregnancies has increased steadily for the last 40 years due to assisted reproductive technology and increased maternal childbearing age. Multiple pregnancies, especially monochorionic twin pregnancies, carry a high risk for the mother and the fetuses and require close follow-up. Twins are exposed to a higher risk of perinatal anoxia, in utero fetal demise, preterm birth, congenital malformations, fetal growth restriction, and vascular complications. Compared to singletons, twins are at higher risk of perinatal mortality and impaired neurodevelopmental outcome, justifying a thorough follow-up by pediatricians, including assessment and management of familial and psychosocial impact. This paper discusses the epidemiological, obstetrical, and genetic issues raised by twin pregnancies and reviews the data on the perinatal and neurological long-term outcomes of twins, as well as the psychosocial impact of multiple births on twins and their families.


    REsumE Avec l’avEnement de la procrEation mEdicalement assistEe (PMA) et le recul de l’Age maternel A la 1 re grossesse, l’incidence des grossesses gEmellaires a fortement augmentE depuis une quarantaine d’annEes. Les risques obstEtricaux et nEonatals liEs A ces grossesses particuliEres dEterminent les modalitEs de suivi A long terme de ces enfants par le pEdiatre. Durant la pEriode pErinatale, les jumeaux sont en effet soumis A un risque accru d’anoxie pErinatale, de prEmaturitE, de malformations congEnitales, de mort fœtale in utero, de retard de croissance intra-utErin (RCIU) et de complications cardiovasculaires – notamment lors des grossesses monochoriales. De ce fait, les jumeaux sont plus A risque, en comparaison des singletons, de dEcEs pErinatal et de troubles neurodEveloppementaux nEcessitant un suivi A long terme, incluant une Evaluation du retentissement familial et psychosocial. Cette revue propose une mise au point des aspects EpidEmiologiques, des enjeux obstEtricaux et gEnEtiques et des risques fœtaux et nEonatals des grossesses gEmellaires, ainsi qu’une synthEse des connaissances sur le devenir de ces enfants et l’impact psychosocial de la gEmellitE.


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