Neonatal outcome following elective cesarean section of twin pregnancies beyond 35 weeks of gestation

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• 作者：Freke A. Wilmink ; MD^a ; Chantal W.P.M. Hukkelhoven ; PhD^b ; Ben Willem J. Mol ; MD ; PhD^c ; Joris A.M. van der Post ; MD ; PhD^c ; Eric A.P. Steegers ; MD ; PhD^a ; Dimitri N.M. Papatsonis ; MD ; PhD^d
• 关键词：cesarean section ; neonatal morbidity ; timing ; twin
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：207
• 期：6
• 页码：480.e1-480.e7
• 全文大小：330 K

文摘

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Objective

We sought to assess neonatal morbidity and mortality of elective cesarean section (CS) of uncomplicated twin pregnancies per week of gestation >35⁺⁰.

Study Design

We performed a retrospective cohort study in our nationwide database including all elective CS of twin pregnancies. Two main composite outcome measures were defined, ie, severe adverse neonatal outcome and mild neonatal morbidity.

Results

We report on 2228 neonates. More than 17 % were born <37⁺⁰ weeks of gestation. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for severe adverse neonatal outcome at 35^+0-6, 36^+0-6, and 37^+0-6 weeks were, OR, 9.4; 95 % CI, 3.2-27.6; OR, 1.7; 95 % CI, 0.5-5.3; and OR, 0.7; 95 % CI, 0.2-2.0, respectively; and for mild neonatal morbidity, OR, 4.7; 95 % CI, 2.6-8.7; OR, 4.9; 95 % CI, 3.1-7.9; and 1.4; 95 % CI, 0.9-2.1, respectively, compared to neonates born ¡Ý38⁺⁰ weeks of gestation.

Conclusion

In uncomplicated twin pregnancies elective CS can best be performed between 37⁺⁰ and 39⁺⁶ weeks of gestation.