The risk of stillbirth and infant death by each additional week of expectant management in twin pregnancies

Jessica M. Page, Rachel A. Pilliod, Jonathan Snowden, Aaron Caughey

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

OBJECTIVE: The objective of the study was to compare the fetal/infant mortality risk associated with each additional week of expectant management with the mortality risk of immediate delivery in women with twin gestations.

STUDY DESIGN: A retrospective cohort study was performed utilizing 2006-2008 National linked birth certificate and death certificate data. The incidence of stillbirth and infant death were determined for each week of pregnancy from 32 0/7 weeks' through 40 6/7 weeks' gestation. Pregnancies complicated by fetal anomalies were excluded. These measures were combined to estimate the theoretic risk of remaining pregnant an additional week by adding the risk of stillbirth during the extra week of pregnancy with the risk of infant death encountered with delivery during the following week. This composite fetal/infant mortality risk was compared with the risk of infant death associated with delivery at the corresponding gestational age.

RESULTS: The risk of stillbirth increased with increasing gestational age, for example, between 37 and 38 weeks' gestation (12.5 per 10,000 vs 22.5 per 10,000; P

CONCLUSION: Our results suggest that fetal/infant death risk is minimized at 37 weeks' gestation; however, individual maternal and fetal characteristics must also be taken into account when determining the optimal timing of delivery for twin pregnancies.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume212
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Twin Pregnancy
Stillbirth
Pregnancy
Fetal Mortality
Infant Mortality
Gestational Age
Birth Certificates
Infant Death
Death Certificates
Fetal Death
Cohort Studies
Retrospective Studies
Mothers
Mortality
Incidence

Keywords

  • expectant management
  • infant death
  • stillbirth
  • twin pregnancy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The risk of stillbirth and infant death by each additional week of expectant management in twin pregnancies. / Page, Jessica M.; Pilliod, Rachel A.; Snowden, Jonathan; Caughey, Aaron.

In: American Journal of Obstetrics and Gynecology, Vol. 212, No. 5, 01.05.2015.

Research output: Contribution to journalArticle

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