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

Freke A. Wilmink, Chantal W.P.M. Hukkelhoven, Ben Willem J. Mol, Joris A.M. Van Der Post, Eric A.P. Steegers, Dimitri N.M. Papatsonis

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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 <38+0 weeks of gestation. Conclusion: In uncomplicated twin pregnancies elective CS can best be performed between 37 +0 and 39+6 weeks of gestation.

Original languageEnglish
Pages (from-to)480.e1-480.e7
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Issue number6
Publication statusPublished - 1 Jan 2012
Externally publishedYes


  • cesarean section
  • neonatal morbidity
  • timing
  • twin

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