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

OBJECTIVE: To compare outcomes at 3 months post partum for women randomised to give birth by planned caesarean section (CS) or by planned vaginal birth (VB) in the Twin Birth Study (TBS). DESIGN: We invited women in the TBS to complete a 3-month follow-up questionnaire. SETTING: Two thousand an...

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Main Authors: Hutton, E.K., Hannah, M.E., Joseph, K.S., Ohlsson, A., Asztalos, Elizabeth, Willan, A.C., Armson, B.A., Gafni, A., Mangoff, K., Sanchez, J.J., Barrett, J.F., Thornton, Jim
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Published: Wiley 2015
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Online Access:https://eprints.nottingham.ac.uk/31862/
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author Hutton, E.K.
Hannah, M.E.
Joseph, K.S.
Ohlsson, A.
Asztalos, Elizabeth
Willan, A.C.
Armson, B.A.
Gafni, A.
Mangoff, K.
Sanchez, J.J.
Barrett, J.F.
Thornton, Jim
author_facet Hutton, E.K.
Hannah, M.E.
Joseph, K.S.
Ohlsson, A.
Asztalos, Elizabeth
Willan, A.C.
Armson, B.A.
Gafni, A.
Mangoff, K.
Sanchez, J.J.
Barrett, J.F.
Thornton, Jim
author_sort Hutton, E.K.
building Nottingham Research Data Repository
collection Online Access
description OBJECTIVE: To compare outcomes at 3 months post partum for women randomised to give birth by planned caesarean section (CS) or by planned vaginal birth (VB) in the Twin Birth Study (TBS). DESIGN: We invited women in the TBS to complete a 3-month follow-up questionnaire. SETTING: Two thousand and eight hundred and four women from 25 countries. POPULATION: Two thousand and five hundred and seventy women (92% response rate). METHODS: 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. MAIN OUTCOME AND MEASURES: Breastfeeding, quality of life, depression, fatigue and urinary incontinence. RESULTS: 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% (P = 0.13); the mean physical and mental Short Form (36) Health Survey (SF-36) quality of life scores were 51.8 versus 51.6 (P = 0.65) and 46.7 versus 46.0 (P = 0.09), respectively; the mean Multidimensional Assessment of Fatigue score was 20.3 versus 20.8 (P = 0.14); the frequency of probable depression on the Edinburgh Postnatal Depression Scale was 14.0% versus 14.8% (P = 0.57); the rate of problematic urinary incontinence was 5.5% versus 6.4% (P = 0.31); and the mean Incontinence Impact Questionnaire-7 score was 20.5 versus 20.4 (P = 0.99). Partner relationships, including painful intercourse, were similar between the groups. CONCLUSION: For women with twin pregnancies randomised to planned CS compared with planned VB, outcomes at 3 months post partum 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. TWEETABLE ABSTRACT: Planned mode of birth for twins doesn't affect maternal depression, wellbeing, incontinence or breastfeeding.
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spelling nottingham-318622020-05-04T20:06:27Z https://eprints.nottingham.ac.uk/31862/ 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 Hutton, E.K. Hannah, M.E. Joseph, K.S. Ohlsson, A. Asztalos, Elizabeth Willan, A.C. Armson, B.A. Gafni, A. Mangoff, K. Sanchez, J.J. Barrett, J.F. Thornton, Jim OBJECTIVE: To compare outcomes at 3 months post partum for women randomised to give birth by planned caesarean section (CS) or by planned vaginal birth (VB) in the Twin Birth Study (TBS). DESIGN: We invited women in the TBS to complete a 3-month follow-up questionnaire. SETTING: Two thousand and eight hundred and four women from 25 countries. POPULATION: Two thousand and five hundred and seventy women (92% response rate). METHODS: 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. MAIN OUTCOME AND MEASURES: Breastfeeding, quality of life, depression, fatigue and urinary incontinence. RESULTS: 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% (P = 0.13); the mean physical and mental Short Form (36) Health Survey (SF-36) quality of life scores were 51.8 versus 51.6 (P = 0.65) and 46.7 versus 46.0 (P = 0.09), respectively; the mean Multidimensional Assessment of Fatigue score was 20.3 versus 20.8 (P = 0.14); the frequency of probable depression on the Edinburgh Postnatal Depression Scale was 14.0% versus 14.8% (P = 0.57); the rate of problematic urinary incontinence was 5.5% versus 6.4% (P = 0.31); and the mean Incontinence Impact Questionnaire-7 score was 20.5 versus 20.4 (P = 0.99). Partner relationships, including painful intercourse, were similar between the groups. CONCLUSION: For women with twin pregnancies randomised to planned CS compared with planned VB, outcomes at 3 months post partum 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. TWEETABLE ABSTRACT: Planned mode of birth for twins doesn't affect maternal depression, wellbeing, incontinence or breastfeeding. Wiley 2015-11 Article PeerReviewed Hutton, E.K., Hannah, M.E., Joseph, K.S., Ohlsson, A., Asztalos, Elizabeth, Willan, A.C., Armson, B.A., Gafni, A., Mangoff, K., Sanchez, J.J., Barrett, J.F. and Thornton, Jim (2015) 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. BJOG: An International Journal of Obstetrics and Gynaecology, 122 (12). pp. 1653-1662. ISSN 1471-0528 Breastfeeding; incontinence; maternal outcomes; postpartum depression; twin pregnancy http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13597/abstract;jsessionid=1B82EDE04577D59CBBA7A4C7AE094F31.f03t01 doi:10.1111/1471-0528.13597 doi:10.1111/1471-0528.13597
spellingShingle Breastfeeding; incontinence; maternal outcomes; postpartum depression; twin pregnancy
Hutton, E.K.
Hannah, M.E.
Joseph, K.S.
Ohlsson, A.
Asztalos, Elizabeth
Willan, A.C.
Armson, B.A.
Gafni, A.
Mangoff, K.
Sanchez, J.J.
Barrett, J.F.
Thornton, Jim
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Breastfeeding; incontinence; maternal outcomes; postpartum depression; twin pregnancy
url https://eprints.nottingham.ac.uk/31862/
https://eprints.nottingham.ac.uk/31862/
https://eprints.nottingham.ac.uk/31862/