OBJECTIVE: This study was undertaken to assess the risk of neonatal morbidity in the second twins. STUDY DESIGN: We carried out a cohort study of 128,219 live born second twins in the United States, 1995 through 1997. The study subjects were divided into 3 groups: second twins delivered by cesarean section after vaginal delivery of the first twin (V-C), both twins delivered vaginally (V-V), and both twins delivered by cesarean section (C-C). RESULTS: The rates of low 5-minute Apgar score, mechanical ventilation, and seizure were higher in the V-C group (8.27%, 13.39%, and 0.31%) than in the V-V (3.07%, 7.51%, and 0.08%) and the C-C (2.66%, 8.53%, and 0.06%) groups. The V-C associated increase in risk remained after adjustment for confounding factors and was more evident at term than preterm. CONCLUSION: The risk of neonatal morbidity is increased in second twins who had a cesarean section after vaginal delivery of the first twin, especially at term.
OBJECTIVE: This study was undertaken to assess the risk of neonatal morbidity in the second twins. STUDY DESIGN: We carried out a cohort study of 128,219 live born second twins in the United States, 1995 through 1997. The study subjects were divided into 3 groups: second twins delivered by cesarean section after vaginal delivery of the first twin (V-C), both twins delivered vaginally (V-V), and both twins delivered by cesarean section (C-C). RESULTS: The rates of low 5-minute Apgar score, mechanical ventilation, and seizure were higher in the V-C group (8.27%, 13.39%, and 0.31%) than in the V-V (3.07%, 7.51%, and 0.08%) and the C-C (2.66%, 8.53%, and 0.06%) groups. The V-C associated increase in risk remained after adjustment for confounding factors and was more evident at term than preterm. CONCLUSION: The risk of neonatal morbidity is increased in second twins who had a cesarean section after vaginal delivery of the first twin, especially at term.
Authors: Margaret Olivia Little; Anne Drapkin Lyerly; Lisa M Mitchell; Elizabeth M Armstrong; Lisa H Harris; Rebecca Kukla; Miriam Kuppermann Journal: Obstet Gynecol Date: 2008-10 Impact factor: 7.661
Authors: Ji Young Kwon; Won Sik Yoon; Gui Se Ra Lee; Sa Jin Kim; Jong Chul Shin; In Yang Park Journal: Int J Med Sci Date: 2011-10-15 Impact factor: 3.738
Authors: Seung Mi Lee; Joong Shin Park; Errol R Norwitz; Sun Min Kim; JoonHo Lee; Chan-Wook Park; Byoung Jae Kim; Jong Kwan Jun Journal: PLoS One Date: 2015-06-15 Impact factor: 3.240