August 10, 2006

No benefit for delivering twins early: study

NEW YORK (Reuters Health) - To reduce the risk of illness
and death, twins should be delivered before 40 weeks of
gestation, but there is no added benefit in delivering them by
38 weeks of gestation, new research suggests. In fact, delivery
at 37 weeks appears to raise the risk of needing assisted

The findings run counter to some reports that have
suggested improved outcomes with delivery by 38 weeks
gestation. Still, other studies, like the current one, have
failed to identify a benefit with earlier delivery.

The latest findings, which appear in the American Journal
of Obstetrics and Gynecology, are based on a look at 60,443
twin pairs that were delivered in the US between 1995 and 1997.
The study only included pregnancies that had reached at least
37 weeks of gestation.

Compared with twins delivered at 37 weeks gestation, those
delivered at or beyond 40 weeks were over 2.5-times more likely
to die.

By contrast, delivery at 38 and 39 weeks gestation did not
significantly increase or decrease mortality relative to
delivery at 37 weeks.

Similarly, delivery at or beyond 40 weeks gestation
increased the risk of low Apgar scores by at least 74 percent,
lead author Dr. Jennifer E. Soucie, from the University of
Ottawa in Ontario, Canada, and colleagues note. Apgar scoring
is a method of quickly checking newborns, based on their heart
rate, breathing, muscle tone, response to stimulus and color.

Delivery at 39 weeks cut the likelihood of ventilation use
by 17 percent relative to delivery at 37 weeks, the report

"This study suggests that the optimal date of delivery for
twins should be

SOURCE: American Journal of Obstetrics and Gynecology July