{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T10:10:09Z","timestamp":1775902209440,"version":"3.50.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Twin gestations are associated with an increased risk of obstetric and perinatal complications. We studied the association between parity and the rate of maternal and neonatal complications in twins deliveries.<\/jats:p><jats:p>\n            Study Design\u2003We performed a retrospective analysis of a cohort of twin gestations delivered between 2012 and 2018. Inclusion criteria consisted of twin gestation with two nonanomalous live fetuses at \u226524 weeks' gestation and no contraindications to vaginal delivery. Women were divided into three groups based on parity: primiparas, multiparas (parity of 1\u20134), and grand multiparas (parity \u22655). Demographic data were collected from electronic patient records and included maternal age, parity, gestational age at delivery, need for induction of labor, and neonatal birth weight. The primary outcome was mode of delivery. Secondary outcomes were maternal and fetal complications.<\/jats:p><jats:p>\n            Results\u2003The study population included 555 twin gestations. One hundred and three were primiparas, 312 were multiparas, and 140 were grand multiparas. Sixty-seven (65%) primiparas delivered the first twin vaginally, as did 294 (94%) multiparas and 133 (95%) grand multiparas (p &lt;0.05). Thirteen (2.3%) women required delivery of the second twin by cesarean section. Among those who delivered both twins vaginally, there was no significant difference in the average time interval between the delivery of the first and the second twins between the groups. The need for transfusion of blood products was higher in the primiparous group compared with the other two groups (11.6 vs. 2.5 and 2.8%, p\u2009&lt;\u20090.05). The rate of adverse maternal composite outcomes was higher among primiparous women compared with multiparous and grand multiparous (12.6, 3.2, and 2.8%, respectively, p\u2009&lt;\u20090.05). The gestational age at delivery was earlier in the primiparous group compared with the other two groups, and the rate of preterm labor at &lt;34 weeks' gestation was higher among the primiparas. The rate of second twin's 5-minute Apgar's score &lt;7 and the composite adverse neonatal outcome among the primiparous group were significantly higher than the multiparous and grand multiparous groups.<\/jats:p><jats:p>\n            Conclusion\u2003Our study demonstrates that there is an association between high-parity and good obstetric outcomes in twin pregnancies; high parity seems to serve as a protective, rather than a risk factor for adverse maternal and neonatal outcomes.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2051-4284","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:24:45Z","timestamp":1678407885000},"page":"e1486-e1490","source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["High-Order Parity Improves the Perinatal Outcome of Twin Deliveries"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7339-2250","authenticated-orcid":false,"given":"Lior","family":"Kashani-Ligumsky","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel"},{"name":"Department of Obstetrics and Gynecology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronnie","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel"},{"name":"Department of Obstetrics and Gynecology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariel","family":"Many","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel"},{"name":"Department of Obstetrics and Gynecology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avshalom","family":"Elmalech","sequence":"additional","affiliation":[{"name":"Department of Information Science, Bar-Ilan University, Ramat Gan, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Neiger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of South Carolina, Columbia, South Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5304-2296","authenticated-orcid":false,"given":"Miriam","family":"Lopian","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak, Israel"},{"name":"Department of Obstetrics and Gynecology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,4,18]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.fertnstert.2006.11.008","article-title":"Contemporary risks of maternal morbidity and adverse outcomes with increasing maternal age and plurality","volume":"88","author":"B Luke","year":"2007","journal-title":"Fertil Steril"},{"issue":"01","key":"ref2","first-page":"1","article-title":"Births: final data for 2015","volume":"66","author":"J A Martin","year":"2017","journal-title":"Natl Vital Stat Rep"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1002\/uog.23620","article-title":"The rate of twin birth is declining","volume":"58","author":"A Khalil","year":"2021","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1097\/AOG.0b013e318292766b","article-title":"Increased stillbirth in uncomplicated monochorionic twin pregnancies: a systematic review and meta-analysis","volume":"121","author":"D Danon","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref5","first-page":"142","article-title":"Obstetric and perinatal outcome of multiple pregnancy","volume":"21","author":"G Qazi","year":"2011","journal-title":"J Coll Physicians Surg Pak"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.ejogrb.2013.06.014","article-title":"Stillbirths in singletons, dichorionic and monochorionic twins: a comparison of risks and causes","volume":"170","author":"F M Russo","year":"2013","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"08","key":"ref7","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.2105\/AJPH.92.8.1323","article-title":"The impact of the increasing number of multiple births on the rates of preterm birth and low birthweight: an international study","volume":"92","author":"B Blondel","year":"2002","journal-title":"Am J Public Health"},{"issue":"04","key":"ref8","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0002-9378(99)70324-8","article-title":"Gestational diabetes mellitus: metabolic and blood glucose parameters in singleton versus twin pregnancies","volume":"181","author":"D B Schwartz","year":"1999","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"490","DOI":"10.4103\/1119-3077.116895","article-title":"Pregnancy outcome and factors affecting vaginal delivery of twins at University of Nigeria Teaching Hospital, Enugu","volume":"16","author":"T O Nwankwo","year":"2013","journal-title":"Niger J Clin Pract"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/1471-0528.12659","article-title":"Advanced maternal age and pregnancy outcomes: a multicountry assessment","volume":"121","author":"M Laopaiboon","year":"2014","journal-title":"BJOG"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"289","DOI":"10.2147\/IJWH.S32190","article-title":"Effect of high parity on occurrence of some fetal growth indices: a cohort study","volume":"4","author":"Y M Al-Farsi","year":"2012","journal-title":"Int J Womens Health"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/0002-9378(95)90593-6","article-title":"The \u201cdangerous multipara\u201d: fact or fiction?","volume":"172","author":"J S Toohey","year":"1995","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1159\/000151750","article-title":"Outcomes of multiplets","volume":"95","author":"E S Shinwell","year":"2009","journal-title":"Neonatology"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/0020-7292(92)91019-K","article-title":"The impact of maternal age on pregnancy and its outcome","volume":"38","author":"M Milner","year":"1992","journal-title":"Int J Gynaecol Obstet"},{"issue":"06","key":"ref15","first-page":"701","article-title":"Low birth weight and its related risk factors in Northeast Iran","volume":"23","author":"R Chaman","year":"2013","journal-title":"Iran J Pediatr"},{"issue":"07","key":"ref16","doi-asserted-by":"crossref","first-page":"707","DOI":"10.4236\/ojog.2017.77071","article-title":"Grand multiparity: obstetric outcome in comparison with multiparous women in a developing country","volume":"07","author":"C O Njoku","year":"2017","journal-title":"OJOG"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1097\/AOG.0b013e3182318651","article-title":"Trends in cesarean delivery for twin births in the United States: 1995-2008","volume":"118","author":"H C Lee","year":"2011","journal-title":"Obstet Gynecol"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2051-4284.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T13:26:05Z","timestamp":1730813165000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2051-4284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,9]]},"references-count":17,"journal-issue":{"issue":"S 01","published-online":{"date-parts":[[2024,5,13]]},"published-print":{"date-parts":[[2024,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2051-4284","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,3,9]]},"published":{"date-parts":[[2023,3,9]]}}}