title: The cost of twin pregnancy: maternal and neonatal factors.
abstract: OBJECTIVE
  The purpose of this study was to evaluate factors affecting birth charges in twin pregnancies.
  
  
  METHODS
  Clinical and financial data were obtained on 1486 twin pregnancies delivered between 1995 to 2002 at medical centers in Maryland, Florida, Michigan, and South Carolina. Maternal and neonatal length of stay (LOS) and charges were modeled by gestational age and other risk factors using a general linear model.
  
  
  RESULTS
  Maternal and infant birth admission LOS and charges increased significantly with a decline in gestational age. Maternal LOS and charges were also significantly increased by cesarean delivery and preeclampsia. Newborn LOS and charges increased significantly by monochorionicity and slowed growth between 20 to 28 weeks. For mother and infants, the shortest LOS and lowest birth charges were at 37 to 38 weeks.
  
  
  CONCLUSIONS
  These findings reflect the substantial maternal and neonatal morbidity associated with twin pregnancies, and demonstrate that 37 to 38 weeks is their optimal gestation.
authors.affiliation: Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, Florida, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Luke
authors.forename: Morton B
authors.initials: MB
authors.lastname: Brown
authors.forename: Pierre K
authors.initials: PK
authors.lastname: Alexandre
authors.forename: Toyin
authors.initials: T
authors.lastname: Kinoshi
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Dibe
authors.initials: D
authors.lastname: Martin
authors.forename: Ruta B
authors.initials: RB
authors.lastname: Misiunas
authors.forename: Clark
authors.initials: C
authors.lastname: Nugent
authors.forename: Cosmas
authors.initials: C
authors.lastname: van de Ven
authors.forename: Roger B
authors.initials: RB
authors.lastname: Newman
authors.forename: Jill G
authors.initials: JG
authors.lastname: Mauldin
authors.forename: Frank R
authors.initials: FR
authors.lastname: Witter
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000191:economics; D005249:Fees and Charges; D005260:Female; D005431:Florida; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008396:Maryland; D008824:Michigan; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000191:economics; D011247:Pregnancy; D011272:Pregnancy, Multiple; D013022:South Carolina; D014427:Twins