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  • Title: Neonatal morbidity by week of gestational age for twins compared to singletons: a population-based cohort study.
    Author: Wolfe K, Tabangin M, Meinzen-Derr J, Snyder C, Lewis D, DeFranco E.
    Journal: Am J Perinatol; 2014 Feb; 31(2):133-8. PubMed ID: 23546846.
    Abstract:
    OBJECTIVE: Quantify neonatal morbidity by week of gestation for twins compared with singletons. STUDY DESIGN: We performed a population-based retrospective cohort study of all Ohio births from 2006 to 2007. Composite neonatal morbidity consisting of Apgar score < 7 at 5 minutes, assisted ventilation > 6 hours, neonatal transport, or seizures was compared between singletons and twins from 34 to 41 weeks. RESULTS: Neonatal morbidity was the lowest in twins delivered at 37 completed weeks and 2 weeks later for singletons at 39 weeks. Twin morbidity rapidly increased after 37 weeks and reached 15.8% at 41 weeks versus the singleton morbidity rate of 3.4% at 41 weeks. Twins delivered at 39 weeks and beyond were more than twice as likely to incur neonatal morbidity compared with singletons. CONCLUSION: The lowest rate of neonatal morbidity occurs at 37 weeks for twins versus 39 weeks for singleton births. The increased risk after 37 weeks for twins accelerates at a faster rate compared with that for singletons born past 39 weeks.
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