They conclude, “In terms of short- and long-term outcomes, uncomplicated twin pregnancies should not be delivered before 37 completed weeks of gestation and that there is a limited benefit of prolonging pregnancy after that.Use our pregnancy due date calculator by plugging in either the date of your last menstrual cycle or the date you know you conceived. The researchers say, “This is the first nationwide study to investigate long-term educational outcomes of twins across the range of gestational age categories.” The rate of SEN is higher among twins, at about 14%, compared to 5% in singletons. Still, available data indicates this to be a rare problem and one that has to be addressed based on individual cases. Similarly, the study does not help to determine the effect of the death of one twin in utero before delivery. The lowest SEN occurs at 37 weeks and beyond with twins.Ī limitation of this study is the lack of sufficient sample size beyond 39 weeks. The birth of twins before 37 weeks is associated with increased perinatal mortality and increased odds of SEN at school. This is the first time that data has been obtained which supports the current clinical guidelines. The findings of this study point to 37 completed weeks of gestation as the best time for the delivery of twin infants, for both short-term and long-term outcomes. And the overall rate of SEN is higher for twins than for singletons. Twin children born before 37 weeks had higher odds of SEN at 34 - 36 weeks, but not after that. The adjusted odds ratio for newborn death for twins was 16 times higher at 34 weeks, and progressively reduced from about 5.6 times, to 1.5 times higher from 35 weeks to 37 weeks. The twins born before 38 weeks were more likely to die in the newborn period compared to infants who were delivered after this period. When competing risks were analyzed, stillbirth risk was markedly less than the risk of neonatal death at 34 and 35 weeks, while the reverse held good after 37 weeks. Twins had increased perinatal mortality, with the odds being over 2.5 times higher at 34-37 weeks compared to birth after that up to 39 weeks. About 60% of mothers were between 25 and 35 years of age, and in 57%, this was their first pregnancy.
The most significant percentage of twins (49%) was observed to be delivered at 37-38 weeks, and 6% were preterm. The resultsīoys and girls were equally represented in the analysis. According to the UK Department of Education, a child with SEN is “unable to benefit fully from school without help beyond that normally given to schoolchildren of the same age.” The investigators included in this category conditions like intellectual disabilities, physical disability, autistic spectrum disorder, language or speech disorders, and psychological or social difficulties. The researchers were looking for extended perinatal mortality, which means death by stillbirth or in the newborn period, and for SEN, special education needs.
Study estimates and compares excess mortality due to cardiovascular diseases across multiple pandemic waves in the US.COVID-19 vaccine inequity increased infection and mortality rates in low and middle-income countries.Can social media influencers impact pregnancy and parenting?.This enabled educational records to be associated with the Morbidity Record. The various relevant registers were used to retrieve the required data – the Scottish Morbidity Record SMR02, the Scottish Stillbirth and Infant Death Survey (SSBID), and the Scottish Exchange of Educational Data (ScotXed). The current cohort study analyzed the outcomes of over 43 000 twins born at 34 weeks or higher between January 1, 1980, and December 31, 2015, in Scotland. The current study was motivated by the need to understand how short-term and permanent outcomes are affected by gestational age. With singletons, the neurodevelopmental outcomes are best with delivery at 41 weeks, but the odds of death around the time of delivery are best at weeks 38-39. Overall, it is considered that twin delivery should be around 37 weeks for dichorionic twins and 36 weeks for monochorionic twins. Most guidelines today operate based on observational studies because of the randomized controlled trials seeking to define the optimal timing of birth. It is therefore vital to know the best time of delivery for twins – a matter which is, strangely, still largely undefined. What is the association of gestational age at the time of the birth of twins with the risk of perinatal mortality and special educational need and what is the optimal week for the birth? Image Credit: Kristina Bessolova / Shutterstock
0 kommentar(er)
