Optimal gestational age for delivery in uncomplicated dichorionic twin pregnancies : a population-based study

Abstract

Objectives: To identify the optimal gestational age for delivery in uncomplicated dichorionic twin pregnancies. Study Design: A retrospective analysis of gestational age-specific neonatal morbidity and mortality data was performed for 254 uncomplicated dichorionic twin pregnancies. Outcome measures included 1st and 5th minute Apgar scores, NICU admission, RDS, TTN, sepsis, seizure, hyperbilirubinemia, hypoglycaemia, neonatal length of hospital stay, birthweight and overall outcome. After correcting for confounding variables by regression analysis, adverse variable trends were assessed in each of the gestational-age- at-birth groups. Results: A significant drop in the incidence of LBW, RDS, TTN and hypoglycaemia, accompanied with the lowest NICU admission rate and neonatal length of hospital stay occurred concordantly at 38 completed weeks of gestation. The incidence of severe hyperbilirubinemia requiring phototherapy decreased significantly by 36 weeks. No correlation was found between advancing gestation and foetal, perinatal or neonatal mortality. Conclusion: Elective delivery in uncomplicated dichorionic twin pregnancies should be delayed until at least 38 completed weeks of gestation as this significantly reduces neonatal morbidity with no impact on mortality.