title: Neonatal outcome of late preterm uncomplicated monochorionic twins: what is the optimal time for delivery?
abstract: OBJECTIVE
  To determine the neonatal outcome at late prematurity of uncomplicated monochorionic (MC) twin pregnancies.
  
  
  METHODS
  A retrospective cohort study of 166 patients with uncomplicated MC diamniotic twins delivered between 34 and 37 weeks of gestation at a single tertiary center. The study population was classified into four groups according to the gestational age at delivery: (1) 34 weeks, (2) 35 weeks, (3) 36 weeks and (4) 37 weeks. Neonatal outcome measures were compared between the groups.
  
  
  RESULTS
  Neonatal morbidity was significantly higher at 34 weeks of gestation compared to the other three groups including respiratory distress syndrome, oxygen requirement, hypothermia and hyperbilirubinemia. Moreover, the rate of admission to the special care unit and need for phototherapy were significantly higher in newborns born at 36 weeks compared to 37 weeks of gestation (p = 0.02 and 0.03 respectively). Multiple regression analysis revealed that the risk for adverse neonatal outcome was significantly associated with gestational age at delivery. Of note, there were no fetal or neonatal deaths in our cohort.
  
  
  CONCLUSIONS
  The risk of neonatal morbidity of uncomplicated MC twins delivered at 34-37 weeks of gestation significantly decreases with advanced gestation. Therefore, under close fetal surveillance, uncomplicated MC twin pregnancies should be delivered at 37 weeks of gestation.
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Berezowsky
authors.affiliation: b Department of Neonatology , Edmond and Lily Safra Children Hospital, Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University , Israel.
authors.forename: Ram
authors.initials: R
authors.lastname: Mazkereth
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaki-Tovi
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Eyal
authors.initials: E
authors.lastname: Schiff
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Boaz
authors.initials: B
authors.lastname: Weisz
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Shlomo
authors.initials: S
authors.lastname: Lipitz
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Yinon
mesh_terms: D000328:Adult; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000453:epidemiology; D007035:Hypothermia / Q000453:epidemiology; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007557:Israel / Q000453:epidemiology; D010102:Oxygen Inhalation Therapy / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D010789:Phototherapy / Q000706:statistics & numerical data; D011247:Pregnancy; D059285:Pregnancy, Twin; D047928:Premature Birth; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D012189:Retrospective Studies; D014430:Twins, Monozygotic
keywords: Late prematurity; monochorionic twins; neonatal outcome; timing of delivery