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. (20th August 2015)

• Record Type: Journal Article
• Authors: Hutton, EK; Hannah, ME; Ross, S; Joseph, KS; Ohlsson, A; Asztalos, EV; Willan, AR; Allen, AC; Armson, BA; Gafni, A; Mangoff, K; Sanchez, JJ; Barrett, JF; the Twin Birth Study Collaborative Group
• Is Part Of: BJOG. Volume 122:Number 12(2015:Dec.)
• Page Start: 1653
• Page End: 1662
• Publication Date: 2015-08-20
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.13597
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo13597-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo13597-sec-0001" sec-type="section"> <title>Objective</title> <p>To compare outcomes at 3 months <italic>post partum</italic> for women randomised to give birth by planned caesarean section (CS) or by planned vaginal birth (VB) in the Twin Birth Study (TBS).</p> </sec> <sec id="bjo13597-sec-0002" sec-type="section"> <title>Design</title> <p>We invited women in the TBS to complete a 3‐month follow‐up questionnaire.</p> </sec> <sec id="bjo13597-sec-0003" sec-type="section"> <title>Setting</title> <p>Two thousand and eight hundred and four women from 25 countries.</p> </sec> <sec id="bjo13597-sec-0004" sec-type="section"> <title>Population</title> <p>Two thousand and five hundred and seventy women (92% response rate).</p> </sec> <sec id="bjo13597-sec-0005" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="bjo13597-sec-0006" sec-type="section"> <title>Main outcome and measures</title> <p>Breastfeeding, quality of life, depression, fatigue and urinary incontinence.</p> </sec> <sec id="bjo13597-sec-0007" sec-type="section"> <title>Results</title> <p>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% (<italic>P</italic> = 0.13); the mean physical and mental Short Form (36) Health Survey (SF‐36) quality of life scores were 51.8 versus 51.6 (<italic>P</italic> = 0.65) and 46.7 versus 46.0 (<italic>P</italic> = 0.09), respectively; the mean Multidimensional Assessment of Fatigue score was 20.3 versus 20.8 (<italic>P</italic> = 0.14); the frequency of probable depression on the Edinburgh Postnatal Depression Scale was 14.0% versus 14.8% (<italic>P</italic> = 0.57); the rate of problematic urinary incontinence was 5.5% versus 6.4% (<italic>P</italic> = 0.31); and the mean Incontinence Impact Questionnaire‐7 score was 20.5 versus 20.4 (<italic>P</italic> = 0.99). Partner relationships, including painful intercourse, were similar between the groups.</p> </sec> <sec id="bjo13597-sec-0008" sec-type="section"> <title>Conclusion</title> <p>For women with twin pregnancies randomised to planned CS compared with planned VB, outcomes at 3 months <italic>post partum</italic> 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.</p> </sec> <sec id="bjo13597-sec-0101" sec-type="section"> <title>Tweetable abstract</title> <p>Planned mode of birth for twins doesn't affect maternal depression, wellbeing, incontinence or breastfeeding.</p> </sec> </abstract>