Impacts of Operative Delivery for the First Twin on Neonatal Outcomes in the Second Twin
Bibliographic record
Abstract
We assess the impacts of operative delivery for the first twins with vertex presentation on neonatal outcomes in second twins using the 1995 to 1997 twin registry data of the United States. A total of 102,554 eligible twin pairs with vertex presentation for the first twin were included in the analysis. Of these, 50,748 (49.5%) first twins had a normal vaginal delivery, 43,504 (42.4%) were delivered by cesarean section, and 8302 (8.1%) were delivered by vaginal operation (vacuum extraction or forceps). In term twins, the risks of asphyxia-related mortality (odds ratio [OR], 3.08; 95% CI, 1.07 to 8.45), newborn injury (OR, 2.10; 95% 1.39 to 3.12), low Apgar score at 5 minutes (OR, 1.49; 95% 1.24 to 1.78), and mechanical ventilation use (OR, 1.34; 95% 1.20 to 1.51) were increased in the second twins whose co-twins were delivered by vaginal operation compared with those whose co-twins who had normal vaginal delivery. In contrast, the risks of asphyxia-related mortality (OR, 0.55; 95% 0.17 to 1.57), newborn injury (OR, 0.20; 95% 0.11 to 0.34), low Apgar score at 5 minutes (OR, 0.51; 95% 0.44 to 0.60), and mechanical ventilation use (OR, 0.77; 95% 0.71 to 0.83) were decreased in the second twins whose co-twins were delivered by cesarean section compared with those whose co-twins had a normal vaginal delivery. In conclusion, vaginal operative delivery for the first twins is related to the adverse neonatal outcomes of their co-twins, whereas cesarean delivery for the first twins is associated with the beneficial neonatal outcomes of their co-twins.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".