Long term outcome of second twins born to mothers who attempted vaginal delivery a retrospective study

To evaluate mortality and long term neurodevelopmental outcomes of the second twins born to mothers who attempted vaginal delivery.

Two hundred and twenty-seven eligible cases of second twin born to mothers who attempted vaginal delivery were identified retrospectively in a ten-year period. Information on adverse long term outcomes (a composite of mortality and neurodevelopmental disorders) were retrieved from their electronic medical record, and the risk factors were determined.

The median follow-up duration was 8 years (range 4-13 years). Adverse composite long term outcomes were observed in 6.6% (15/227). Gestation at delivery < 32 week (p = 0.001) and inter-twin delivery interval of > 30 min (P = 0.000) were significantly associated with adverse long term outcomes of the second twin on multivariate analysis. Second twins in the combined vaginal- caesarean birth group had no significant increase in adverse outcomes compared to those in the vaginal-vaginal birth group.

Adverse long term outcomes were uncommon among second twins born to mothers who attempted vaginal delivery. Adverse outcomes were associated with prematurity and inter-twin delivery interval of more than 30 min, but not with actual mode of delivery.