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Objective This study was undertaken to assess the risk of neonatal morbidity in the second twi ns.Study design We carried out a cohort study of 128,219live born second twins in the United States,1995thro ugh 1997.The study subjects were divided into 3groups: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,me chanical ventila-tion,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 confo unding factors and was more evident at term than preterm.Co nclusion The risk of neonatal morbidity is increased in s econd 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 twi ns.Study design We carried out a cohort study of 128,219live born second twins in the United States, 1995th ugh 1997.The study subjects were divided into 3groups: 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 sections (C -C.) Results The rates of low 5-minute Apgar score, me chanical ventilation and seizure were higher in the VC group (8.27%, 13.39%, and 0.31%) than in the V-V (3.07%, 7.51%, and 0.08% 2.66%, 8.53%, and 0.06%) groups.The V -C associated increase in risk remained after adjustment for confo unding factors and was more evident at term than preterm. Co nclusion The risk of neonatal morbidity is increased in s econd twins who had a cesarean section after vaginal delivery of the first twin, especially at term.