Second Twins Born at Term at Higher Risk of Death

A higher risk of death from anoxia in at-term second twins delivered vaginally

MONDAY, March 5 (HealthDay News) -- Second twins born at term have a more than twofold higher risk of death compared with first twins, primarily due to labor and delivery complications, according to a report published online March 2 in BMJ. Second twins born at term and delivered by Caesarean section have a lower risk of death from anoxia compared with those born vaginally.

Gordon C.S. Smith, M.D., Ph.D., of Cambridge University in the United Kingdom, and colleagues estimated the risk of perinatal death based on birth order in 1,377 twin pregnancies between 1994 and 2003. In each pregnancy studied, there was one perinatal death from causes other than congenital abnormality and one surviving infant.

The researchers found that although birth order had no effect on the overall risk of death, second twins born at term had a significantly higher risk of death (odds ratio 2.3), "principally because of complications of labor and delivery." For twins born at term, second twins born vaginally rather than by Caesarean tended to be at greater risk of death from anoxia (OR, 4.1 versus 1.8).

"In this cohort, compared with first twins, second twins born at term were at increased risk of perinatal death related to delivery," Smith and colleagues conclude.

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