Neonatal mortality and morbidity rates in term twins with advancing gestational age - 18/08/11
Abstract |
Objective |
The purpose of this study was to identify the gestational age with the lowest morbidity and mortality rates for twin pregnancies that reach term.
Study design |
A retrospective cohort study carried out with 60,443 twin pairs from the United States (1995-1997). Analysis was restricted to pregnancies that had reached at least 37 weeks of gestation; groups were created on the basis of the gestational ages of 37, 38, 39, and ≥40 weeks. The incidence of death and morbidity were calculated; multiple logistic regression models were used to estimate the independent effect of gestational age for twin A and B.
Results |
The neonatal mortality rate increased significantly after 40 weeks of gestation (twin A: odds ratio, 3.47 [95% CI, 2.29, 5.38]; twin B, odds ratio, 2.52 [95% CI, 1.75, 3.67]). There was also an increased risk of neonatal morbidity in the ≥40 weeks of gestation group for twin A and B (Apgar score, ≤3; odds ratio, 1.88 [95% CI, 1.18, 3.02], 1.74 [95% CI, 1.21, 2.52], respectively). There was a decreased risk of assisted ventilation in the 38 and 39 weeks of gestation group for twin A (odds ratio, 0.86 [95% CI, 0.77, 0.97], odds ratio, 0.83 [95% CI, 0.72, 0.95], respectively) and a decreased risk in the 39 and ≥40 weeks of gestation groups for twin B (assisted ventilation: odds ratio, 0.83 [95% CI, 0.73, 0.93], odds ratio, 0.81 [95% CI, 0.72, 0.92], respectively).
Conclusion |
This study suggests that the optimal date of delivery for twins should be <40 weeks of gestation; there was no compelling evidence for delivering at <38 weeks of gestation.
Le texte complet de cet article est disponible en PDF.Key words : Twins, Gestational age, Morbidity, Mortality
Plan
Vol 195 - N° 1
P. 172-177 - juillet 2006 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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