Hutton E K, Hannah M E, Ross S, Joseph K S, Ohlsson A, Asztalos E V, Willan A R, Allen A C, Armson B A, Gafni A, Mangoff K, Sanchez J J, Barrett J F
Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.
BJOG. 2015 Nov;122(12):1653-62. doi: 10.1111/1471-0528.13597. Epub 2015 Aug 20.
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).
We invited women in the TBS to complete a 3-month follow-up questionnaire.
Two thousand and eight hundred and four women from 25 countries.
Two thousand and five hundred and seventy women (92% response rate).
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.
Breastfeeding, quality of life, depression, fatigue and urinary incontinence.
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.
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.
Planned mode of birth for twins doesn't affect maternal depression, wellbeing, incontinence or breastfeeding.
在双胎分娩研究（TBS）中，比较随机分配接受计划剖宫产（CS）或计划阴道分娩（VB）的女性产后3个月的结局。
我们邀请TBS中的女性完成一份3个月的随访问卷。
来自25个国家的2804名女性。
2570名女性（应答率92%）。
在2003年12月13日至2011年4月4日期间TBS中随机分组的女性完成了一份问卷，并采用意向性分析方法比较结局。
母乳喂养、生活质量、抑郁、疲劳和尿失禁。
我们发现两组在任何结局方面均无临床重要差异。在计划剖宫产组与计划阴道分娩组中，产后任何时间进行母乳喂养的比例分别为84.4%和86.4%（P = 0.13）；简明健康调查量表（SF-36）身体和精神生活质量的平均得分分别为51.8和51.6（P = 0.65）以及46.7和46.0（P = 0.09）；疲劳多维评估的平均得分分别为20.3和20.8（P = 0.14）；爱丁堡产后抑郁量表上可能存在抑郁的频率分别为14.0%和14.8%（P = 0.57）；有问题的尿失禁发生率分别为5.5%和6.4%（P = 0.31）；尿失禁影响问卷-7的平均得分分别为20.5和20.4（P = 0.99）。两组之间的伴侣关系，包括性交疼痛，相似。
对于双胎妊娠且随机分配接受计划剖宫产与计划阴道分娩的女性，产后3个月的结局无差异。分娩方式与有问题的尿失禁或影响生活质量的尿失禁无关。与先前的研究相反，计划阴道分娩并未增加3个月时的母乳喂养率。
双胞胎的计划分娩方式不影响母亲的抑郁、健康、尿失禁或母乳喂养。
