Neonatal mortality in second twin according to cause of death, gestational age, and mode of delivery.
OBJECTIVE
The purpose of this study was to assess the risk of neonatal death in the second twin.


METHODS
We carried out a retrospective cohort study of 128,219 live born second twins in the United States for the years 1995 through 1997. The study subjects were divided into 3 groups: second twins who were delivered by cesarean delivery after vaginal delivery of the first twin (group 1), both twins delivered vaginally (group 2), and both twins delivered by cesarean delivery (group 3).


RESULTS
The risk of asphyxia-related neonatal deaths was increased in groups 1 and 2; the increased risk in group 1 was stronger in term births than in preterm births.


CONCLUSIONS
The risk of neonatal deaths, especially for term infants with asphyxia-related deaths, is increased for the second twins who are delivered by cesarean delivery after vaginal delivery of the first twins.
Wen
Shi Wu
SW
OMNI Research Group, Division of Maternal-Fetal Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. swwen@ohri.ca
Fung Kee Fung
Karen
K
Oppenheimer
Lawrence
L
Demissie
Kitaw
K
Yang
Qiuying
Q
Walker
Mark
M
D000328:Adult; D001238:Asphyxia Neonatorum / Q000401:mortality; D001722:Birth Order; D002423:Cause of Death; D002585:Cesarean Section; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods*; D004200:Diseases in Twins / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D016017:Odds Ratio; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D014427:Twins