Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #101288

Qiuying Yang¹, Shi Wu Wen¹, Jennifer Soucie, Karen Fung Kee fung³, and Mark Walker¹. (1) OMNI group, Ottawa Health Research Institute, University of Ottawa, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada, (613)7378899 ext 73046, qyang@ohri.ca, (2) Department of Obstetrics and gynecology, University of Ottawa, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada

To estimate if there is an increased risk of neonatal mortality in term twins with advancing gestational age. We conducted a historical cohort study based on twin registry data (1995-97) in the United States. Multiple logistic regressions were used to estimate the effect of gestational age on neonatal death adjusting for potential confounding. There were a total of 60,443 twins set with a gestational age of 37 to 40 weeks in the database. The crude rates of all cause death for first twins were 0.17 % in gestational age of 37 weeks, 0.14 % in 38 weeks, 0.12% in 39 weeks and 0.98% in 40 weeks. Corresponding figures for second twins were 0.28%, 0.24%, 0.20% and 0.96%, respectively. The crude rates of non-congenital anomaly-related death for first twins were 0.06% in gestational age of 37 weeks, 0.07% in 38 weeks, 0.07% in 39 weeks and 0.79% in 40 weeks. Corresponding figures for second twins were 0.14%, 0.08%, 0.11% and 0.79%, respectively. The adjusted odds ratios for non-congenital anomaly-related death in first twins were 1.16 (0.52, 2.61), 1.10 (0.41, 2.75) and 12.00 (6.79, 23.62), respectively, for gestational age of 38 weeks, 39 weeks, and 40+ weeks, as compared with 37 weeks. Corresponding figures for second twins were 0.61 (0.32, 1.12), 0.81 (0.40, 1.54) and 5.26 (3.46, 8.21), respectively. We concluded that delaying delivery of twin pregnancy to 40 weeks of gestation carries a substantially increased risk of neonatal death to both first and second twins.

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