Perinatal mortality and neonatal morbidity rates among twin pairs at different gestational ages: Optimal delivery timing at 37 to 38 weeks’ gestation

Indicated and Non-Indicated Preterm Delivery in Twin Gestations: Impact on Neonatal Outcome and Cost

“…11 Some studies have suggested that it is prudent to intervene in twin pregnancies at 37 to 38 weeks' gestation, and that due to an increased risk of mortality and morbidity, twin pregnancies should not continue beyond 39 weeks' gestation. 10,12 While previous authors have shown that optimal pregnancy outcomes occur earlier in twin versus singleton gestations, 12 there are no data to support preterm intervention when there is no maternal or fetal indication necessitating delivery. The preterm birth rate in the United States remains unacceptably high.…”

“…4 Other studies also link a decrease in gestational age at delivery to increased NICU admission and length of stay. [8][9][10] In a study over a 10-year period of more than 8000 twin pairs, it was discovered that significantly higher perinatal morbidity and mortality rates were associated with delivery at r35 weeks' gestation. 10 Undoubtedly, prematurity is correlated to low birth weight, NICU admission and greater lengths of stay.…”

“…[8][9][10] In a study over a 10-year period of more than 8000 twin pairs, it was discovered that significantly higher perinatal morbidity and mortality rates were associated with delivery at r35 weeks' gestation. 10 Undoubtedly, prematurity is correlated to low birth weight, NICU admission and greater lengths of stay. These factors have a tremendous emotional and financial impact on the parents of these babies.…”

Intrauterine Growth and Cerebral Palsy in Twins: A European Multicenter Study

“…This gestational age is suggested to be 'term' for twins (i.e., where fetal and neonatal standards should coincide) as optimal perinatal survival occurs 2 weeks earlier in twins compared with singletons (Allen & Donohue, 2002;Hartley et al, 2001;Kiely, 1998;Minakami & Sato, 1996), possibly associated with accelerated organ maturation (Allen & Donohue, 2002;Leveno et al, 1984). This approach is similar to that used by Gardosi et al (1995) for creating singleton fetal growth charts and in effect assumes that the twin growth trajectory from the Min's standard (USA; Min et al, 2000) can be applied to other populations of twins which differ in their mean expected term weight.…”

How Bereaved Multiple-Birth Parents Cope with Hospitalization, Homecoming, Disposition for Deceased, and Attachment to Survivors

“…1 Moreover, a first trimester ''vanished twin'' occurs in 20 to 50% of multifetal pregnancies, 2 and later fetal loss happens in up to 5% of twin and 18% of triplet gestations. 2,3 Compared to parents of singletons, parents of multiples in neonatal intensive care units (NICUs) tend to have greater anxiety and attach differently to their children. [4][5][6] Parents who conceive twins via assisted reproductive techniques report less prenatal anxiety, but greater parenting stress than those with spontaneously conceived multiples.…”