title: The Association between the Intertwin Interval and Adverse Neonatal Outcomes.
abstract: ObjectivePrevious data examining the association between the interval between the delivery of the first and second twin (intertwin interval) and adverse neonatal outcomes are conflicting. We sought to evaluate whether intertwin interval is associated with adverse neonatal outcomes for the second twin in a contemporary U. S. cohort.MethodsThis is a cohort study of women who delivered twins at or after 32 weeks gestation between 2006 and 2014 and whose first twin was delivered vaginally vertex. The intertwin interval was dichotomized as < 10 minutes or ≥ 10 minutes. Adverse outcomes included arterial cord pH ≤ 7.1, admission to the neonatal intensive care unit, respiratory distress, intraventricular hemorrhage, and death.ResultsOf the 171 subjects, 61 (35.7%) had an intertwin interval of ≥ 10 minutes. There were no differences in maternal characteristics. Intertwin interval of ≥ 10 minutes was associated with an increased frequency of arterial pH ≤ 7.1 (22.0 vs. 8.2%,p= 0.03), which persisted after adjusting for confounders (adjusted odds ratio, 2.94; 95% confidence interval, 1.04-8.33). Other adverse outcomes did not differ.ConclusionIntertwin interval of ≥ 10 minutes was associated with increased frequency of arterial pH ≤ 7.1 in the second twin, but no other adverse neonatal outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Kate
authors.initials: K
authors.lastname: Swanson
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: William A
authors.initials: WA
authors.lastname: Grobman
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Miller
mesh_terms: D000074042:Cerebral Intraventricular Hemorrhage / Q000453:epidemiology*; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D066087:Perinatal Death; D011247:Pregnancy; D059285:Pregnancy, Twin; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D014427:Twins / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology