BMJ  2007;334 (17 March), doi:10.1136/bmj.39155.711400.43

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It's all about being first

The first 150 words of the full text of this article appear below.

In the age-old competition among siblings, it's always been advantageous to be the first child. Firstborn sons, for example, may have special claims to family money, titles, or other assets. First children may get extra parental attention and time, and may be more successful at school or work than their later born siblings. As it turns out, though, for twins it is not just life's rewards but life itself that may hinge on being born first. Gordon Smith and colleagues (doi: 10.1136/bmj.39118.483819.55) performed a retrospective cohort study of over 1300 twin pregnancies in which one twin died and the other survived. For preterm infants, perinatal deaths were largely related to complications of prematurity and not birth order. For vaginal deliveries of twins at term, however, the second twin was at increased risk of death. The authors cautiously suggest that planned caesarean section for twin deliveries might reduce this risk. . . . [Full text of this article]

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