title: Neonatal outcome following elective cesarean section of twin pregnancies beyond 35 weeks of gestation.
abstract: OBJECTIVE
  We sought to assess neonatal morbidity and mortality of elective cesarean section (CS) of uncomplicated twin pregnancies per week of gestation >35(+0).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  In uncomplicated twin pregnancies elective CS can best be performed between 37(+0) and 39(+6) weeks of gestation.
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Freke A
authors.initials: FA
authors.lastname: Wilmink
authors.forename: Chantal W P M
authors.initials: CW
authors.lastname: Hukkelhoven
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
authors.forename: Joris A M
authors.initials: JA
authors.lastname: van der Post
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Dimitri N M
authors.initials: DN
authors.lastname: Papatsonis
mesh_terms: D000328:Adult; D002585:Cesarean Section; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology*; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D059285:Pregnancy, Twin; D012042:Registries; D012189:Retrospective Studies