Perinatology.  2018 Dec;29(4):159-164. 10.14734/PN.2018.29.4.159.

Neonatal Respiratory Morbidity in Twins according to Birth Order and Mode of Delivery

• Kim H
• Kim J
• Ko SY
• Shin SM
• Lee YK

• KMID: 2430218
• DOI: http://doi.org/10.14734/PN.2018.29.4.159

Abstract

OBJECTIVE
To compare neonatal respiratory morbidity of twins according to birth order related to gestational age and mode of delivery.
METHODS
We performed the retrospective research of the medical records of 3,224 neonates (1,612 twin pairs) born in a single center from January 2011 to December 2015. Subjects were classified into four gestational age groups: very ( < 32 weeks), moderate (32-33 weeks), late (34-36 weeks) preterm, and term (≥37 weeks) groups. We investigated clinical characteristics and respiratory morbidity according to birth order related to gestational age group and mode of delivery.
RESULTS
We found increased risk of respiratory morbidity in second-born twin than first-born twin (P=0.039). Second-born twin was associated with increased risk of respiratory distress syndrome (RDS) in late preterm group (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.30-5.95), and transient tachypnea of newborn in term group (OR 1.4, 95% CI 1.03-1.81). In vaginal delivery mode, there was no difference of respiratory morbidity between first and second-born twin in each group, but in cases of Cesarean delivery, second-born twin was related with a greater risk of RDS in late preterm group (OR 2.3, 95% CI 1.07-5.09). Birth order and Cesarean section independently increased the risk of RDS (adjusted OR [aOR] 1.69, 95% CI 1.12-2.54; aOR 2.14, 95% CI 1.25-3.66, respectively).
CONCLUSION
Second-born twin and Cesarean delivery are associated with increased risk of RDS, especially in late preterm twins.

Keyword

Respiratory distress syndrome; newborn; Cesarean section; Birth order; Twins

MeSH Terms

Birth Order*
Cesarean Section
Female
Gestational Age
Humans
Infant, Newborn
Medical Records
Parturition*
Pregnancy
Retrospective Studies
Transient Tachypnea of the Newborn
Twins*

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