ArticleAmerican journal of obstetrics and gynecology2015
The risk of stillbirth and infant death by each additional week of expectant management in twin pregnancies.
Article in American journal of obstetrics and gynecology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global prevalence of stillbirth among fetuses from twin pregnancies: a systematic review and meta-analysis.Archives of gynecology and obstetrics · 2025Pooled it
- Observational
- Perinatal and postpartum care during the COVID-19 pandemic: A nationwide cohort study.Birth (Berkeley, Calif.) · 2022Article
- Prevalence and outcomes of twin pregnancies in Botswana: a national birth outcomes surveillance study.BMJ open · 2021Article
- [Role of endoplasmic reticulum stress-induced apoptosis of trophoblasts in intrahepatic cholestasis during pregnancy].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2018Article
- Optimal Timing of Delivery Based on the Risk of Stillbirth and Infant Death Associated with Each Additional Week of Expectant Management in Multiple Pregnancies: a National Cohort Study of Koreans.Journal of Korean medical science · 2018Article
- A Consilience of Inductions Supports the Extended Fetuses-at-Risk Model.Paediatric and perinatal epidemiology · 2016Article
- Australian national birthweight percentiles by sex and gestational age for twins, 2001-2010.BMC pediatrics · 2015Article
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4 authors.
Funding
Abstract
objectiveThe 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
designA 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.
resultsThe 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<.05). As expected, the risk of infant death following delivery gradually decreased as pregnancies approached term gestation. Week-by-week differences were statistically significant (P<.05) between 32 and 36 weeks with decreasing risk of infant death at advancing gestational ages. The composite risk of stillbirth and infant death associated with an additional week of pregnancy had a significant increase from 37 to 38 weeks' gestation (43.9 per 10,000 vs 59.2 per 10,000; P<.05). At 37 weeks' gestation, the relative risk of mortality was statistically significantly lower with immediate delivery as compared with expectant management (relative risk, 0.87; 95% confidence interval, 0.77-0.99).
conclusionOur 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.
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