When to Deliver Uncomplicated Twin Pregnancies?

Excess risk for stillbirth in twin pregnancies commonly underlies the recommendation to deliver before the due date, even in the absence of complications — still, the gestational ages at which risks for stillbirth and neonatal complications are minimized have not been determined. In a meta-analysis of global data from 32 cohort studies, researchers evaluated week-by-week risks for fetal death in undelivered twin pregnancies and neonatal death in those delivered after 34 weeks.

Among dichorionic twins, risks for fetal and neonatal death were similar at 37 weeks' gestation (3.4 stillbirths/1000 pregnancies and 2.2 neonatal births/1000 pregnancies); in subsequent weeks, risk for stillbirth (10.6/1000) dwarfed risk for neonatal death (1.5/1000).…