{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:01:10Z","timestamp":1793178070131,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,8,20]],"date-time":"2015-08-20T00:00:00Z","timestamp":1440028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["63164"],"award-info":[{"award-number":["63164"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare outcomes at 3\u00a0months <jats:italic>post partum<\/jats:italic> for women randomised to give birth by planned caesarean section (<jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>) or by planned vaginal birth (<jats:styled-content style=\"fixed-case\">VB<\/jats:styled-content>) in the Twin Birth Study (<jats:styled-content style=\"fixed-case\">TBS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We invited women in the <jats:styled-content style=\"fixed-case\">TBS<\/jats:styled-content> to complete a 3\u2010month follow\u2010up questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two thousand and eight hundred and four women from 25 countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Two thousand and five hundred and seventy women (92% response rate).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women randomised between 13 December 2003 and 4 April 2011 in the <jats:styled-content style=\"fixed-case\">TBS<\/jats:styled-content> completed a questionnaire and outcomes were compared using an intention\u2010to\u2010treat approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome and measures<\/jats:title><jats:p>Breastfeeding, quality of life, depression, fatigue and urinary incontinence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found no clinically important differences between groups in any outcome. In the planned <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> versus planned <jats:styled-content style=\"fixed-case\">VB<\/jats:styled-content> groups, breastfeeding at any time after birth was reported by 84.4% versus 86.4% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.13); the mean physical and mental Short Form (36) Health Survey (<jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\u201036) quality of life scores were 51.8 versus 51.6 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.65) and 46.7 versus 46.0 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.09), respectively; the mean Multidimensional Assessment of Fatigue score was 20.3 versus 20.8 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.14); the frequency of probable depression on the Edinburgh Postnatal Depression Scale was 14.0% versus 14.8% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.57); the rate of problematic urinary incontinence was 5.5% versus 6.4% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.31); and the mean Incontinence Impact Questionnaire\u20107 score was 20.5 versus 20.4 (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.99). Partner relationships, including painful intercourse, were similar between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For women with twin pregnancies randomised to planned <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> compared with planned <jats:styled-content style=\"fixed-case\">VB<\/jats:styled-content>, outcomes at 3\u00a0months <jats:italic>post partum<\/jats:italic> 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\u00a0months was not increased with planned <jats:styled-content style=\"fixed-case\">VB<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Planned mode of birth for twins doesn't affect maternal depression, wellbeing, incontinence or breastfeeding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13597","type":"journal-article","created":{"date-parts":[[2015,9,2]],"date-time":"2015-09-02T12:04:42Z","timestamp":1441195482000},"page":"1653-1662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Maternal outcomes at 3\u00a0months after planned caesarean section versus planned vaginal birth for twin pregnancies in the Twin Birth Study: a randomised controlled trial"],"prefix":"10.1111","volume":"122","author":[{"given":"EK","family":"Hutton","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences 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Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EV","family":"Asztalos","sequence":"additional","affiliation":[{"name":"Department of Newborn and Developmental Paediatrics Sunnybrook Health Sciences Center University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AR","family":"Willan","sequence":"additional","affiliation":[{"name":"Ontario Child Health Support Unit Sickkids Research Institute and Dalla Lana School of Public Health University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AC","family":"Allen","sequence":"additional","affiliation":[{"name":"Pediatrics IWK Health Center Dalhousie University Halifax NS Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BA","family":"Armson","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology IWK Health Center Dalhousie University Halifax NS 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