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Poster Session 2

(508) Sibling Analysis of Long-Term Morbidities in Preterm Twins: Vaginal versus Cesarean Delivery

Thursday, January 30, 2025
4:00 PM – 6:00 PM  

    Submitting Author(s)

  • Itamar Ben Shitrit, MPH (he/him/his)

    Medical analyst/student
    Soroka University Medical Center/ Ben Gurion University
    Beer Sheva, HaDarom, Israel

    • Presenting Author(s)

  • Eyal Sheiner, MD, PhD

    Head of department of Obstetrics and Gynecology, Soroka University Medical Center
    Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Beer Sheva, HaDarom, Israel

    • Coauthor(s)

  • Gali Pariente, MD

    Acting director of Fetal Maternal Unit B Division of Obstetrics and Gynecology
    Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Beer Sheva, HaDarom, Israel

  • RS

    Ruslan Sergienko, MHA

    Data Science, Statistical Programming & Analysis, Advanced Data Management
    Ben-Gurion University of the Negev
    Beer Sheva, HaDarom, Israel

  • Tamar Wainstock, PhD (she/her/hers)

    Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
    Beer Sheva, HaDarom, Israel

Objective:

Given the gap in knowledge regarding mode of delivery’s impact on the premature twin population, we aimed to investigate the association between mode of delivery and long-term respiratory, neurologic, infectious, and gastrointestinal (GI) morbidities in preterm twin siblings, with the first delivered vaginally (VD) and the second by cesarean delivery (CD).

Study Design:

A retrospective population-based cohort study was conducted at a tertiary medical center between 1991-2021. The study compared preterm twins where the first-born twin was vaginally delivered, and the second-born twin was delivered via CD, excluding cases with congenital malformations or perinatal deaths. Follow-up ended at the age of 18, end of the study period, or diagnoses of any morbidity from the studied outcomes. Kaplan-Meier survival curves were used to compare cumulative incidences, and Cox proportional hazards models were applied to adjust for potential confounders.

Results:

The cohort included 71 offspring born via CD and 71 via VD, representing 3.5% of all preterm twin births at this center. No difference in the cumulative incidence of respiratory, neurologic, infectious, and gastrointestinal morbidity was noted between the groups (respiratory: 24% VD vs. 23% CD, p=0.85; neurologic: 12% VD vs. 12% CD, p=1.00; infectious: 52% VD vs. 45% CD, p=0.20; GI: 20% VD vs. 17% CD, p=0.56, Table, Figure). Similarly, the Cox model, adjusted for maternal age, ethnicity, gestational age group, repeated pregnancies, offspring’s birth year, gestational diabetes mellitus, preeclampsia, weight group, and clustering within pregnancy, showed no association between delivery mode and long-term morbidity (respiratory: aHR 0.93, 95% CI 0.56–1.55; neurologic: aHR 1.16, 95% CI 0.47–2.27; infectious: aHR 0.81, 95% CI 0.59–1.12; GI: aHR 0.86, 95% CI 0.47–1.59, Table).

Conclusion:

No significant differences in long-term respiratory, neurologic, infectious, and GI morbidities exist between preterm twin siblings when the first-born was delivered vaginally and the second-born by CD. Further research on larger cohorts is needed to confirm these findings.