Perinatology

The Korean Society of Perinatology (대한주산의학회)
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Neonatal Respiratory Morbidity in Twins according to Birth Order and Mode of Delivery

  • Kim, Hyunsoo (Department of Pediatrics, Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine) ;
  • Kim, Jiyeon (Department of Pediatrics, Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine) ;
  • Ko, Sun Young (Department of Pediatrics, Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine) ;
  • Shin, Son Moon (Department of Pediatrics, Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine) ;
  • Lee, Yeon Kyung (Department of Pediatrics, Cheil General Hospital and Women's Health Care Center, Dankook University College of Medicine)
  • Received : 2018.06.15
  • Accepted : 2018.08.26
  • Published : 2018.12.31
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Abstract

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 (${\geq}37weeks$) 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.

Keywords

References

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