Fertility treatment as a risk factor for maternal request of cesarean delivery in twin pregnancies

Rania Okby, Yura Druyan, Molly Sonenklar, Barak Aricha-Tamir, Kira Nahum Sacks, Eyal Sheiner

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objective: A marked increase in the overall cesarean delivery (CD) rate of twin pregnancies has recently been observed. We sought to examine the obstetrical characteristics of patients who chose a non-indicated CD and to investigate the trends in the rate of CD for maternal request over a 5 years period. Study design: A cross sectional retrospective study of twin pregnancies, compared obstetrical characteristics between patients who chose a non-indicated CD and those who delivered vaginally. Deliveries occurred during 2006 and 2011 in a regional tertiary medical center. Patients with any indication for a CD were excluded. A multivariate logistic regression was used to control for confounders. Results: 525 twins were included at the study, 61.7 % (n = 324) were delivered by CD. Of these, 28.7 % (n = 93) were non-indicated. Between the years 2006 and 2011, there was a significant decrease in the rate of non-indicated CD (34.9 vs 23.8 %, OR = 0.58, 95 % CI 0.35–0.94, P = 0.02). Deliveries after fertility treatments or a previous CD had a higher rate of non-indicated CD (51.6 vs. 27.4 %, P < 0.001 and 26.9 vs. 3.5 %, P < 0.001; respectively). In the multivariate analysis, maternal age (OR = 1.08, 95 % CI 1.01–1.15), previous CD (OR = 15.75, 95 % CI 5.82–42.67) and fertility treatments (OR = 2.16, 95 % CI 1.14–4.10) were found to be independent risk factors for a non-indicated CD. Furthermore, parity was found to be an independent protective factor (OR = 0.75, 95 % CI 0.61–0.92). Conclusion: In our study population, there was a significant decrease in the rate of non-indicated CD over a five-year period. Maternal age, fertility treatments and previous CD were found to be independent risk factors for non-indicated CD in twin pregnancies.

Original languageEnglish
Pages (from-to)1183-1187
Number of pages5
JournalArchives of Gynecology and Obstetrics
Volume294
Issue number6
DOIs
StatePublished - 1 Nov 2016
Externally publishedYes

Keywords

  • Cesarean delivery
  • Maternal request
  • Twin pregnancy

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