Periventricular leukomalacia and mode of delivery in twins under 1500 g.
BACKGROUND
The optimal mode of delivery in twin gestations remains undefined, particularly for twins weighing less than 1500 g.


OBJECTIVE
To evaluate the impact of the mode of delivery on neonatal outcome in twins below 1500 g.


METHODS
In this multicenter cohort study during 1999, 66 sets of twins born in hospital and weighing below 1500 g formed our study group. Antenatal and neonatal parameters and their relationship to mode of delivery were studied, based on a factor analysis. Analysis of covariance was used to assess the effect of the mode of delivery on postnatal factors, with antenatal parameters used as covariates.


RESULTS
Statistical analysis showed that infants delivered vaginally had significantly more periventricular leukomalacia than those children delivered by Cesarean section (p = 0.03). The estimated odds for leukomalacia were higher in the vaginal than in the Cesarean group when adjusted for covariates (OR = 4.7; 95% CI = 1.0, 25.15).


CONCLUSIONS
Routine Cesarean section should be recommended in twin gestations with infants weighing less than 1500 g, regardless of gestational age or fetal presentation.
Salomon
L J
LJ
Service de Gynécologie-Obstérique, Centre Hospitalier Intercommunal de Poissy-St Germain, Poissy, France.
Duyme
M
M
Rousseau
A
A
Audibert
F
F
Paupe
A
A
Zupan
V
V
Ville
Y
Y
D001724:Birth Weight; D002585:Cesarean Section; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods*; D004200:Diseases in Twins / Q000453:epidemiology*; D005260:Female; D005317:Fetal Growth Retardation / Q000150:complications; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007969:Leukomalacia, Periventricular / Q000453:epidemiology*; D011247:Pregnancy