Perinatal outcomes significantly better at 38 versus 36, 37 weeks; no significant difference at 39 weeks
THURSDAY, Nov. 1 (HealthDay News) -- To minimize perinatal morbidity and mortality, the optimal time for delivery of twins is at 38 weeks of gestation or later, according to a study published in the November issue of the American Journal of Obstetrics & Gynecology.
Amy E. Doss, M.D., of the University of Alabama School of Medicine in Birmingham, and colleagues conducted a retrospective study of 377 twin gestations delivered at 36 weeks of gestation or later in a single institution. The authors sought to determine the optimal gestational age for delivering twins, based on a composite of perinatal death, respiratory distress, suspected sepsis, and need for neonatal intensive care.
Of the twin gestations included, 83 percent were dichorionic. The researchers found that spontaneous labor occurred in 53 percent of deliveries, and that 48 percent were delivered via cesarean section. The overall rates of the composite outcome decreased as gestational age increased, with the lowest composite rate seen at 38 weeks. Perinatal outcomes were significantly better at 38 weeks than at 36 or 37 weeks, but there was no significant difference for outcomes at 38 weeks and those at 39+ weeks.
"This study showed that the lowest rate of composite perinatal morbidity and mortality for twin gestations was at 38 weeks," the authors write. "Compared with 38 weeks, there was a six-fold increase in the composite outcome at 36 weeks and a nearly three-fold increase at 37 weeks."
Abstract
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