Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

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

Journal of Perinatology volume 25, pages 4–7 (2005)Cite this article

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML . Births: Final Data for 2002 National Vital Statistics Reports, Vol.52, No.10. Hyattsville, MD: National Center for Health Statistics; 2003.

  2. Lam F, Bergauer NK, Jacques D, Coleman SK, Stanziano GJ . Clinical and cost-effectiveness of continuous subcutaneous terbutaline versus oral tocolytics for treatment of recurrent preterm labor in twin gestations. J Perinatol 2001;21:444–450.

    Article  CAS  Google Scholar 

  3. Gardner MO, Goldenberg RL, Cliver SP, Tucker JM, Nelson KG, Copper RL . The origin and outcome of preterm twin pregnancies. Obstet Gynecol 1995;85:553–557.

    Article  CAS  Google Scholar 

  4. Büscher U, Horstkamp B, Wessel J, Chen FCK, Dudenhausen JW . Frequency and significance of preterm delivery in twin pregnancies. Int J Gynaecol Obstet 2000;69:1–7.

    Article  Google Scholar 

  5. Knuppel RA, Lake MF, Watson DL, et al. Preventing preterm birth in twin gestation: home uterine activity monitoring and perinatal nursing support. Obstet Gynecol 1990;76:24S–27S.

    CAS  PubMed  Google Scholar 

  6. Roberts WE, Morrison JC . Has the use of home monitors, fetal fibronectin, and measurement of cervical length helped predict labor and/or prevent preterm delivery in twins? Clin Obstet Gynecol 1998;41:95–102.

    Article  Google Scholar 

  7. Luke B, Bigger HR, Leurgans S, Sietsema D . The cost of prematurity: a case–control study of twins versus singletons. Am J Public Health 1996;86:809–814.

    Article  CAS  Google Scholar 

  8. Joseph KS, Allen AC, Dodds L, Vincer MJ, Armson BA . Causes and consequences of recent increases in preterm birth among twins. Obstet Gynecol 2001;98:57–64.

    CAS  PubMed  Google Scholar 

  9. Dyson DC, Crites YM, Ray DA, Armstrong MA . Prevention of preterm birth in high-risk patients: the role of education and provider contact versus home uterine monitoring. Am J Obstet Gynecol 1991;164:756–762.

    Article  CAS  Google Scholar 

  10. Hartley RS, Emanuel I, Hitti J . Perinatal mortality and neonatal morbidity rates among twin pairs at different gestational ages: optimal delivery timing at 37 to 38 weeks' gestation. Am J Obstet Gynecol 2001;184:451–458.

    Article  CAS  Google Scholar 

  11. Ladden M . The impact of preterm birth on the family and society: Part 1: psychologic sequelae of preterm birth. Pediatr Nurs 1990;16:515–518.

    CAS  PubMed  Google Scholar 

  12. Warner BB, Kiely JL, Donovan EF . Multiple births and outcome. Clin Perinatol 2000;27 (2):347–361.

    Article  CAS  Google Scholar 

  13. Kogen MD, Alexander GR, Kotelchuck M, et al. Trends in twin birth outcomes and prenatal care utilization in the United States, 1981–1997. JAMA 2000;283:335–341.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Good Samaritan Medical Center, Phoenix, AZ, USA

    John P Elliott MD

  2. Matria Healthcare, Marietta, GA, USA

    Niki B Istwan RN, BS, Ann Collins RNC, BSN, Debbie Rhea MPH & Gary Stanziano MD

Authors
  1. John P Elliott MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Niki B Istwan RN, BS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ann Collins RNC, BSN
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Debbie Rhea MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gary Stanziano MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Elliott, J., Istwan, N., Collins, A. et al. Indicated and Non-Indicated Preterm Delivery in Twin Gestations: Impact on Neonatal Outcome and Cost. J Perinatol 25, 4–7 (2005). https://doi.org/10.1038/sj.jp.7211205

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211205

This article is cited by

Search

Advanced search

Quick links