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BJOG. 2015 Nov;122(12):1653-62. doi: 10.1111/1471-0528.13597. Epub 2015 Aug 20.

Maternal outcomes at 3 months after planned caesarean section versus planned vaginal birth for twin pregnancies in the Twin Birth Study: a randomised controlled trial.

Collaborators (277)

Castaldi JL, Deguer C, Bertin MS, Partida Y, Galimberti D, Messina A, Voto LS, Voto GN, Prieto MJ, Buraschi F, Sexer H, Palermo M, Varela DM, Franzé F, Benitez P, Garcia V, Savransky R, Dunaievsky A, Andina E, Laterra C, Susacasa S, Frailuna MA, Almansa SR, Barrere MB, García H, Rivero M, Gomez EE, Schinini J, Ahlbom M, Aguirre JD, Morales EM, Abreo GI, de Sagastizabal MT, de Lourdes Martín R, Videla A, Mesas W, Arias C, Castagnola MC, Gorostiaga RA, Curioni M, Mohedano M, Dip V, Roque A, Duhalde EM, Dodd J, Deussen A, Crowther C, Gardener G, Chaplin J, Wilkins D, Mahomed K, Green A, Baade R, Haran M, Hanafy A, Davis G, Roberts L, Tucker S, Duncan C, Watson D, Lawrence A, Laubach M, Breugelmans R, Calderon I, Martins A, Magalhães C, Cecatti JG, Surita FG, Rosado L, Vidal AC, de Souza GR, Maia Filho NL, Santana DS, de Sa RA, Marcolino L, Marques CC, Zanella PL, Milan C, Bollis MD, Steibel G, Moreira S, Lima AC, Scavuzzi A, de Souza AS, de Moraes Filho OB, Carvalho SA, de Sa RA, Bornia RG, da Silva NR, de Sa RA, Spinola R, Lopes LM, Sass N, Korkes H, Chalem E, Yokota EJ, de Faria Silveira MR, Wood S, Miller L, McLeod L, Armson BA, Mueller V, Gregorovich S, Moore E, Gratton R, Kennedy L, Scheufler P, Reid D, Klam S, Daitchman R, Farquharson D, Harrison K, Kulkarni R, Scarfone R, Laplante J, Carson G, Williams S, Rosman D, Nemtean D, Olatunbosun F, Pierson K, Crane J, Hutchens D, Okun N, Zaltz A, Brown M, Ornstein M, Visram S, Bordin J, Siurna H, Petruskavich S, Kaye S, Haslauer KA, Cundiff G, Gomez R, Kusanovic JP, Neculman KS, Valenzuela LL, Leiva EM, Cabrera JG, Ravanal MM, Orrego RS, Matijevic R, Makhlouf A, Saber O, Abdelradey T, Kirss F, Rull K, Vaas P, Hopp H, Nonnenmacher A, Michaelis S, Hasbargen U, Delius M, Major T, Bartha T, Salim R, Harel L, Chayen B, Siev S, Hallak M, Mei-Dan E, Gonen R, Wolff L, Wolfson E, Sadan O, Mansour-Schwake D, Petchinkin L, Hakim M, Perlitz Y, Ben-Ami M, Pansky S, Simms-Stewart D, Wilson M, El-Zibdeh M, AlFaris L, Ziekenhuis SL, Heres M, Sluis A, Roumen FJ, Rinkens J, Willekes C, Alleman S, van Zandvoort SG, Porath MM, Verhoeven C, Mol BW, Radfar F, Khan S, Preis K, Swiatkowska-Freund M, Krasomski G, Kesiak M, Krekora M, Zych K, Wilczynski J, Breborowicz G, Dera A, Rahman Su, Al-Jassim AA, Stamatian F, Caracostea G, Gojnic M, Fazlagic A, Perovic M, Vasiljevic B, Stefanovic T, Gonce A, Rodriguez SH, Massanes M, Moratonas EC, Rodriguez CR, Martinez SA, Llurba E, Franch AS, de la Calle M, Dans F, Sancha M, Lopez S, Canete Palomo ML, Maldonado del Valle MD, Rodríguez Martín MN, Lázaro-Carrasco Delgado C, Jiménez Fournier MC, Ojutiku D, Masuku M, Goodsell K, Southam D, Tuffnell D, Germaine T, Palethorpe R, Farrar D, Wright J, Al-Taher H, Meehan H, Bricker L, Dower M, Houghton G, Pascall A, Longworth H, Sau A, Thornton J, Fisher J, Houda M, Simm A, Bugg G, Deshpande R, Davis Y, Holloway F, Bugg G, Welch R, Hollands H, Young P, Hinshaw K, Bargh A, Edmundson D, Cameron H, Rossell P, Alonso J, Austt AG, Ortiz A, Burgis J, Brown S, Gregg A, Borowski K, Fleener D, Deaver J, Sumersille M, Aronoff C, Bland K, Kontopoulos E, Rivero Y, Lovett SM, Zatinsky S, Diogo M, Coonrod DV, Jimenez BF.

Author information

1
Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
2
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.
3
Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada.
4
Obstetrics and Gynaecology and School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
5
Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
6
Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Center, University of Toronto, Toronto, ON, Canada.
7
Ontario Child Health Support Unit, Sickkids Research Institute and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
8
Pediatrics, IWK Health Center, Dalhousie University, Halifax, NS, Canada.
9
Obstetrics and Gynecology, IWK Health Center, Dalhousie University, Halifax, NS, Canada.
10
Center for Mother, Infant and Child Research, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.

Abstract

OBJECTIVE:

To compare outcomes at 3 months post partum for women randomised to give birth by planned caesarean section (CS) or by planned vaginal birth (VB) in the Twin Birth Study (TBS).

DESIGN:

We invited women in the TBS to complete a 3-month follow-up questionnaire.

SETTING:

Two thousand and eight hundred and four women from 25 countries.

POPULATION:

Two thousand and five hundred and seventy women (92% response rate).

METHODS:

Women randomised between 13 December 2003 and 4 April 2011 in the TBS completed a questionnaire and outcomes were compared using an intention-to-treat approach.

MAIN OUTCOME AND MEASURES:

Breastfeeding, quality of life, depression, fatigue and urinary incontinence.

RESULTS:

We found no clinically important differences between groups in any outcome. In the planned CS versus planned VB groups, breastfeeding at any time after birth was reported by 84.4% versus 86.4% (P = 0.13); the mean physical and mental Short Form (36) Health Survey (SF-36) quality of life scores were 51.8 versus 51.6 (P = 0.65) and 46.7 versus 46.0 (P = 0.09), respectively; the mean Multidimensional Assessment of Fatigue score was 20.3 versus 20.8 (P = 0.14); the frequency of probable depression on the Edinburgh Postnatal Depression Scale was 14.0% versus 14.8% (P = 0.57); the rate of problematic urinary incontinence was 5.5% versus 6.4% (P = 0.31); and the mean Incontinence Impact Questionnaire-7 score was 20.5 versus 20.4 (P = 0.99). Partner relationships, including painful intercourse, were similar between the groups.

CONCLUSION:

For women with twin pregnancies randomised to planned CS compared with planned VB, outcomes at 3 months post partum did not differ. The mode of birth was not associated with problematic urinary incontinence or urinary incontinence that affected the quality of life. Contrary to previous studies, breastfeeding at 3 months was not increased with planned VB.

TWEETABLE ABSTRACT:

Planned mode of birth for twins doesn't affect maternal depression, wellbeing, incontinence or breastfeeding.

KEYWORDS:

Breastfeeding; incontinence; maternal outcomes; postpartum depression; twin pregnancy

PMID:
26328526
PMCID:
PMC5014197
DOI:
10.1111/1471-0528.13597
[Indexed for MEDLINE]
Free PMC Article

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