Maternal parity and obstetric outcomes among twin deliveries

We studied the association between parity and maternal and neonatal outcomes among twin deliveries. We conducted a retrospective analysis of twin deliveries outcomes by parity. Inclusion criteria included pregnancies >24 weeks and cephalic position of the presenting twin. Exclusion criteria included previous cesarean delivery. Women were divided into three groups based on parity: primiparas, multiparas (parity of 1-4), and grandmultiparas (parity ≥5). Primary outcome was mode of delivery. Secondary outcomes included maternal blood transfusion, ICU admission, 5 minute Apgar score and NICU admission of term neonates ( >37 weeks). We analyzed the outcomes of 575 women. There were 108 primiparas, 265 multiparas and 202 grandmultiparas. Delivery was significantly earlier in the primipara group vs. multiparas and grandmultiparas (36+1 vs. 36+5 and 36+5 weeks, respectively, p=0.01). Sixty-nine (63.9%) of primiparas delivered vaginally as did 240 (90.6%) multiparas and 189 (93.6%) grandmultiparas (p value< 0.001). Blood products transfusion rate was lower in the grandmultipara group compared with multiparas and primiparas (3.4%, 3.7% and 12.03%, p=0.002). The rate of second twin's 5 minute Apgar score < 7 was higher in the primipara group (7.4% vs. 0.3% and 0%, p< 0.001). There were no differences in rates of maternal ICU admissions and NICU admissions of term neonates. Our study suggests that among twin pregnancies, higher parity is associated with favorable maternal and neonatal outcomes compared to the outcome of women with low-order parity.