{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:07:02Z","timestamp":1759334822263,"version":"build-2065373602"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study aimed to investigate odds of vaginal delivery comparing induced versus spontaneous labor in nulliparas and multiparas with dichorionic twins.<\/jats:p><jats:p>A retrospective review of dichorionic twin pregnancies from 2008 to 2021. Those with scheduled or elective cesarean, malpresentation, prior uterine surgery, fetal anomaly, gestational age (GA) at delivery &lt;34 weeks, and multifetal reduction were excluded. Nulliparas and multiparas were analyzed separately. The primary outcome was vaginal delivery of both twins. Secondary outcomes included preterm delivery, postpartum hemorrhage, and hypertensive disorders of pregnancy (HDP). Outcomes were compared among induced versus spontaneous labor and assessed using univariable and multivariable logistic regression.<\/jats:p><jats:p>Among 258 nulliparas, 176 (68.2%) were induced, and 82 (31.8%) spontaneously labored. Induced patients were older (p\u2009=\u20090.048), had a higher proportion of intrahepatic cholestasis of pregnancy (IHCP; p\u2009=\u20090.04), HDP (p\u2009&lt;\u20090.0001), and later GA at delivery (p\u2009&lt;\u20090.0001). Patients who spontaneously labored had a higher proportion of preterm delivery at &lt;37 weeks (p\u2009&lt;\u20090.0001) and a higher proportion of at least one twin admitted to the neonatal intensive care unit (p\u2009=\u20090.01). On univariable analysis, induction was associated with decreased likelihood of vaginal delivery of both twins (p\u2009=\u20090.01). However, after adjusting for augmentation, GA at delivery, gestational diabetes, and HDP\/chronic hypertension, this was no longer statistically significant (p\u2009=\u20090.14). Among 239 multiparas, 108 (45.2%) were induced, and 131 (54.8%) spontaneously labored. Induced patients had a higher proportion of IHCP (p\u2009=\u20090.02), chronic hypertension (p\u2009=\u20090.02), HDP (p\u2009&lt;\u20090.0001), and later GA at delivery (p\u2009&lt;\u20090.0001). Spontaneous labor patients had higher proportion of preterm delivery at &lt;37 weeks (p\u2009&lt;\u20090.0001). There was no significant difference in odds of vaginal delivery between spontaneous versus induced labor on univariate (p\u2009=\u20090.74) or adjusted analysis after controlling for augmentation, GA at delivery, gestational diabetes and HDP\/chronic hypertension (p\u2009=\u20090.40) among multiparas.<\/jats:p><jats:p>Among nulliparas and multiparas with dichorionic twins, induction of labor does not appear to be associated with decreased odds of vaginal delivery.<\/jats:p>","DOI":"10.1055\/a-2547-4074","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T19:09:51Z","timestamp":1740683391000},"page":"1875-1884","source":"Crossref","is-referenced-by-count":0,"title":["Mode of Delivery Outcomes of Induced versus Spontaneous Labor in Individuals with Dichorionic Twins"],"prefix":"10.1055","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6105-6249","authenticated-orcid":false,"given":"Manasa G.","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Medical Center, New York"},{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9532-4109","authenticated-orcid":false,"given":"Chelsea A.","family":"DeBolt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy, Center for Biostatistics, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia G.","family":"Khurana","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, New York University, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Band","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2769-209X","authenticated-orcid":false,"given":"Elianna","family":"Kaplowitz","sequence":"additional","affiliation":[{"name":"Department of Population Health Science and Policy, Center for Biostatistics, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei","family":"Rebarber","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan S.","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Stone","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1097\/00006250-200006000-00022","article-title":"Maternal morbidity and mortality associated with multiple gestations","volume":"95","author":"A Conde-Agudelo","year":"2000","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1097\/AOG.0000000000001338","article-title":"Twin pregnancy and severe maternal outcomes","volume":"127","author":"D S Santana","year":"2016","journal-title":"Obstet Gynecol"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"e145","DOI":"10.1097\/AOG.0000000000004397","article-title":"Multifetal gestations: Twin, triplet, and higher-order multifetal pregnancies: ACOG Practice Bulletin, Number 231","volume":"137","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2014Obstetrics, Society for Maternal-Fetal Medicine","year":"2021","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1016\/S0002-9378(00)70350-4","article-title":"Hypertensive disorders in twin versus singleton gestations","volume":"182","author":"B M Sibai","year":"2000","journal-title":"Am J Obstet Gynecol"},{"issue":"14","key":"ref5","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1056\/NEJMoa1214939","article-title":"A randomized trial of planned cesarean or vaginal delivery for twin pregnancy","volume":"369","author":"J FR Barrett","year":"2013","journal-title":"N Engl J Med"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1186\/s12884-020-03369-x","article-title":"Cesarean delivery or induction of labor in pre-labor twin gestations: a secondary analysis of the twin birth study","volume":"20","author":"C Dougan","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12884-016-1201-8","article-title":"The effect of induction method in twin pregnancies: a secondary analysis for the twin birth study","volume":"17","author":"E Mei-Dan","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"issue":"05","key":"ref8","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"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.ejogrb.2016.08.031","article-title":"Trends in the delivery route of twin pregnancies in the United States, 2006-2013","volume":"205","author":"Z H Bateni","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"100470","DOI":"10.1016\/j.ajogmf.2021.100470","article-title":"Mode of delivery in multiple pregnancies","volume":"4","author":"A Aviram","year":"2022","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1097\/01.AOG.0000444441.04111.1d","article-title":"Obstetric care consensus no. 1: safe prevention of the primary cesarean delivery","volume":"123","author":"American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine","year":"2014","journal-title":"Obstet Gynecol"},{"issue":"03","key":"ref12","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.ajog.2014.01.026","article-title":"Safe prevention of the primary cesarean delivery","volume":"210","author":"A B Caughey","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/AOG.0b013e31825f3643","article-title":"Induction of labor in twin compared with singleton pregnancies","volume":"120","author":"M Taylor","year":"2012","journal-title":"Obstet Gynecol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ejogrb.2019.04.005","article-title":"Risk of cesarean after induction of labor in twin compared to singleton pregnancies","volume":"237","author":"C Loscul","year":"2019","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"124.e1","DOI":"10.1016\/j.ajog.2023.11.1230","article-title":"A prediction tool for mode of delivery in twin pregnancies-a secondary analysis of the Twin Birth Study","volume":"231","author":"A Aviram","year":"2024","journal-title":"Am J Obstet Gynecol"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1097\/AOG.0000000000002048","article-title":"Association between planned cesarean delivery and neonatal mortality and morbidity in twin pregnancies","volume":"129","author":"T Schmitz","year":"2017","journal-title":"Obstet Gynecol"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"100724","DOI":"10.1016\/j.srhc.2022.100724","article-title":"Induction of labor in twin pregnancies - A retrospective cohort study","volume":"32","author":"I Mikaelsen","year":"2022","journal-title":"Sex Reprod Healthc"},{"issue":"05","key":"ref18","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.3390\/jcm12052041","article-title":"Induction of labor in twins-double trouble?","volume":"12","author":"M Lopian","year":"2023","journal-title":"J Clin Med"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"106.e1","DOI":"10.1016\/j.ajog.2014.07.056","article-title":"Risk factors for cesarean delivery in twin pregnancies attempting vaginal delivery","volume":"212","author":"N S Fox","year":"2015","journal-title":"Am J Obstet Gynecol"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"B2","DOI":"10.1016\/j.ajog.2018.08.009","article-title":"SMFM Statement on Elective Induction of Labor in Low-Risk Nulliparous Women at Term: the ARRIVE Trial","volume":"221","author":"Society of Maternal-Fetal (SMFM) Publications Committee. Electronic address: pubs@smfm.org","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1056\/NEJMoa1800566","article-title":"Labor induction versus expectant management in low-risk nulliparous women","volume":"379","author":"W A Grobman","year":"2018","journal-title":"N Engl J Med"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0020-7292(02)00006-1","article-title":"Induction of labor in twin pregnancy after 36 weeks does not increase maternal-fetal morbidity","volume":"77","author":"T Harle","year":"2002","journal-title":"Int J Gynaecol Obstet"},{"issue":"01","key":"ref23","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1186\/s12884-015-0566-4","article-title":"Induction of twin pregnancy and the risk of caesarean delivery: a cohort study","volume":"15","author":"M Jonsson","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"issue":"01","key":"ref24","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1097\/AOG.0b013e31821e5f65","article-title":"Indications contributing to the increasing cesarean delivery rate","volume":"118","author":"E L Barber","year":"2011","journal-title":"Obstet Gynecol"},{"issue":"08","key":"ref25","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1515\/jpm-2015-0401","article-title":"Neonatal outcomes of twin pregnancies delivered at late-preterm versus term gestation based on chorionicity and indication for delivery","volume":"44","author":"J H Sung","year":"2016","journal-title":"J Perinat Med"},{"issue":"01","key":"ref26","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1111\/j.1471-0528.2007.01556.x","article-title":"Increased perinatal mortality and morbidity in monochorionic versus dichorionic twin pregnancies: clinical implications of a large Dutch cohort study","volume":"115","author":"K E Hack","year":"2008","journal-title":"BJOG"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1097\/AOG.0000000000004483","article-title":"Mode of delivery in monochorionic compared with dichorionic twin pregnancies","volume":"138","author":"H N Lesser","year":"2021","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-2547-4074.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T22:38:34Z","timestamp":1759271914000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2547-4074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,27]]},"references-count":27,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2025,9,30]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2547-4074","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"type":"print","value":"0735-1631"},{"type":"electronic","value":"1098-8785"}],"subject":[],"published-other":{"date-parts":[[2025,2,27]]},"published":{"date-parts":[[2025,2,27]]}}}