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KMID : 1101620180290040159
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Perinatology
2018 Volume.29 No. 4 p.159 ~ p.164
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Neonatal Respiratory Morbidity in Twins according to Birth Order and Mode of Delivery
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Kim Hyun-Soo
Kim Ji-Yeon
Ko Sun-Young
Shin Son-Moon
Lee Yeon-Kyung
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Abstract
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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.
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KEYWORD
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Respiratory distress syndrome, newborn, Cesarean section, Birth order, Twins
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