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Randomized Controlled Trial
. 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

E K Hutton  1 , M E Hannah  2 , S Ross  3 , K S Joseph  4 , A Ohlsson  5 , E V Asztalos  6 , A R Willan  7 , A C Allen  8 , B A Armson  9 , A Gafni  1 , K Mangoff  10 , J J Sanchez  10 , J F Barrett  2 ; Twin Birth Study Collaborative Group
Collaborators, Affiliations
Randomized Controlled Trial

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

E K Hutton et al. BJOG. 2015 Nov.

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.

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References

    1. Barrett JFR, Hannah ME, Hutton EK, Willan AR, Allen AC, Armson BA, et al. A randomized trial of planned cesarean or vaginal delivery for twin pregnancy. N Engl J Med 2013;369:1295–305. - PMC - PubMed
    1. Saurel‐Cubizolles MJ, Romoito P, Lelong N, Ancel PY. Women's health after childbirth: a longitudinal study in France and Italy. BJOG 2000;107:1202–9. - PubMed
    1. Brown SJ, Lumley J. Physical health problems after childbirth and maternal depression at six to seven months. Br J Obstet Gynaecol 2000;107:1194–201. - PubMed
    1. Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: pediatric cost analysis. Pediatrics 2010;125:e1048–56. - PubMed
    1. Renfrew MJ, Pokhrel S, Quigley M, McCormick F, Fox‐Rushby J, Dodds R, et al. Preventing Disease and Saving Resources: The Potential Contribution of Increasing Breastfeeding Rates in the UK. London: UNICEF; 2012.

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