Impact of mode of delivery on perinatal outcome in moderately and late preterm twin birth

Objective To examine the impact of the mode of delivery on neonatal and maternal outcomes in moderately and late preterm twin birth.

Methods This single-center cohort study included 275 live diamniotic moderately and late preterm twin deliveries at 32(+0)-36(+6) weeks of gestation. These twin deliveries were divided into two groups according to the planned mode of delivery: trial of labor (TOL) (N=199, 72.4%) and planned cesarean section (CS) (N=76, 27.6%). The primary outcome was neonatal morbidity. Maternal outcome and the effects of gestational age and chorionicity on neonatal outcome were also studied.

Results Of the women in the TOL group, 170 (85.4%) delivered vaginally. Both for the first and second twin, and for dichorionic or monochorionic deliveries, there were no differences between the TOL and CS groups in composite neonatal morbidity or in other neonatal outcomes. No significant differences were found between the TOL and CS groups when the moderately and late preterm gestational age cohorts were studied separately. Mothers in the planned CS group more often had puerperal infection and surgical complications in comparison with mothers in the TOL group.

Conclusion Among 275 moderately and late preterm twin deliveries, planned mode of delivery did not affect neonatal outcome.