ASSOCIATION OF PRELABOR CESAREAN DELIVERY WITH REDUCED MORTALITY IN TWINS BORN NEAR TERM: A RETROSPECTIVE COHORT STUDY

Abstract

Background: The management of twin pregnancies poses unique challenges, particularly regarding the mode of delivery. This study examines the association between pre-labor cesarean delivery and neonatal mortality and morbidity in twins born near term.

Methods: A retrospective cohort study was conducted at a tertiary care hospital in India, including twin pregnancies delivered between January 2010 and December 2015. The study population consisted of 1,200 twin pregnancies delivered at or beyond 34 weeks of gestation. The primary outcome was neonatal mortality, with secondary outcomes including Apgar scores, NICU admissions, and perinatal complications. Data were analyzed using chi-square tests, t-tests, and multivariable logistic regression.

Results: Prelabor cesarean delivery was associated with a significantly lower neonatal mortality rate compared to vaginal delivery (1.5% vs. 3.5%, p=0.01). Higher Apgar scores at 1 and 5 minutes, fewer NICU admissions, and reduced perinatal complications were also observed in the cesarean delivery group.

Conclusion: Prelabor cesarean delivery in twin pregnancies near term is associated with reduced neonatal mortality and better neonatal outcomes. These findings support considering prelabor cesarean delivery as a beneficial mode of delivery in managing near-term twin pregnancies.

Keywords: Twin pregnancies, Prelabor cesarean delivery, Neonatal mortality, Neonatal outcomes, Perinatal Complications.