Outcomes of non-vertex second twins, following vertex vaginal delivery of first twin: a secondary analysis of the WHO Global Survey on Maternal and Perinatal Health

Table 5 Perinatal outcomes, by fetal presentation of the second twin

	Non-vertex n/N, (%) N = 369	Vertex n/N, (%) 1,055	Crude odds ratio (95% CI)	Adjusted odds ratio^a(95% CI)
Stillbirth	28/369 (7.6)	50/1055 (4.7)	1.65 (1.02 – 2.66)	1.15 (0.72 – 1.73)
Early neonatal mortality	14/369 (3.8)	22/1055 (2.1)	1.86 (0.94 – 3.67)	1.68 (0.96 – 2.94)
Apgar score <7 at 5 minutes	59/369 (16.0)	120/1050 (11.4)	1.48 (1.05 – 2.07)	1.42 (1.01 – 2.00)*
Admission to NICU	98/369 (26.6)	245/1055 (23.2)	1.20 (0.91 – 1.58)	0.93 (0.62 – 1.39)

^aGeneralized linear mixed models adjusted for: maternal age (<20, 20-35, >35), maternal education (0, 1-4, 5-9, > = 10), parity, (0, 1-2, > = 3), antenatal visits (0, 1-3, > = 4), mode of delivery (vaginal or caesarean), hypertensive diseases (chronic or pregnancy-induced hypertension), malaria, other medical diseases (HIV, pregestational diabetes, cardiac/renal disease, chronic respiratory conditions, sickle cell anaemia), prelabour rupture of membranes, pre-eclampsia/eclampsia, vaginal bleeding in 2^nd half of pregnancy and urine infection/pyelonephritis, sex, sex discordance (yes/no), gestational age (<37 or > =37 weeks), birthweight (<2500 g or > =2500 g) and birthweight discordance (<15%, larger twin of >15% birthweight discordant pair, smaller twin of >15% birthweight discordant pair); country and facility as random effects.

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