Original Article

Journal of Perinatology (2005) 25, 4–7. doi:10.1038/sj.jp.7211205 Published online 14 October 2004

Indicated and Non-Indicated Preterm Delivery in Twin Gestations: Impact on Neonatal Outcome and Cost

John P Elliott MD1, Niki B Istwan RN, BS2, Ann Collins RNC, BSN2, Debbie Rhea MPH2 and Gary Stanziano MD2

  1. 1Good Samaritan Medical Center (J.P.E.), Phoenix, AZ, USA
  2. 2Matria Healthcare (N.B.I., A.C., D.R., G.S.), Marietta, GA, USA

Correspondence: John Elliott, MD, Department of Maternal-Fetal Medicine, Good Samaritan Medical Center, 1111 East McDowell Road, Phoenix, AZ 85006, USA

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Abstract

OBJECTIVE:

 

To identify the etiology and impact of preterm delivery in twin gestations.

STUDY DESIGN:

 

Twin gestations delivered at 33.0 to 36.9 weeks were identified in a perinatal database, and categorized by indication for delivery. Deliveries were identified as indicated, or non-indicated (discretionary). Neonatal outcomes were measured by birth weight, length of stay, NICU admission, and ventilator utilization. Data were divided and analyzed by indicated or discretionary delivery, and gestational age at delivery.

RESULTS:

 

Analyzed were 3252 twin gestations (6504 infants), with 78% having indicated delivery. Of the 22% with discretionary delivery, nearly 40% required NICU admission. With each advancing week of gestation, there was a significant decrease in incidence of NICU admission and nursery days.

CONCLUSION:

 

The majority of preterm deliveries were indicated, though 22% were discretionary. It is vital to consider neonatal morbidity and costs related to gestational age when choosing discretionary delivery.

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