{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:35:26Z","timestamp":1764333326907,"version":"3.37.3"},"reference-count":24,"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\u2003This work aimed to identify possible risk factors and the morbidity associated with prolonged intertwin delivery interval (IDI).<\/jats:p><jats:p>\n            Study Design\u2003A retrospective cohort study at a single tertiary care center. Women with twin gestations who reached the second stage of labor between January 2010 and December 2019 were included in the study. Demographic and clinical characteristics were compared between short IDI (\u226415\u2009minutes) and prolonged IDI (&gt;15\u2009minutes). The primary outcome was the rate of 5-minute Apgar score \u2264 7.<\/jats:p><jats:p>\n            Results\u2003A total of 461 women were included; 312 of whom were in the short IDI group and 149 were in the prolonged IDI group. Rates of 5-minute Apgar score \u2264 7 and neonatal acidemia were significantly higher in the prolonged IDI group (3.5 vs. 9.7%, p\u2009=\u20090.008; 4.3 vs. 15.7%, p\u2009=\u20090.01, respectively). Vaginal delivery was less likely to occur in the prolonged IDI group (75.8 vs. 93.3%). Placental abruption and hemoglobin drop \u2265 3\u2009g\/dL were more prevalent in the prolonged IDI group (4 vs. 1%, p\u2009=\u20090.03; 39.1 vs. 24.7%, p\u2009=\u20090.01, respectively). In the multivariate analysis, age \u2265 30 years (adjusted odds ratio [aOR]: 1.76, p\u2009=\u20090.01), nulliparity (aOR: 1.66, p\u2009=\u20090.03), and birth weight ratio \u2265 1.2 (aOR: 1.92, p\u2009&lt;\u20090.05) were associated with prolonged IDI.<\/jats:p><jats:p>\n            Conclusion\u2003Prolonged IDI is associated with an increased risk for neonatal acidemia and low 5-minute Apgar score, and with an increased rate of cesarean delivery, placental abruption, and hemoglobin drop \u2265 3\u2009g\/dL. Advanced maternal age, nulliparity, and twin birth weight ratio \u2265 1.2 are associated with prolonged IDI.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0043-1772229","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T22:56:50Z","timestamp":1691621810000},"page":"e2587-e2592","source":"Crossref","is-referenced-by-count":3,"special_numbering":"S","title":["Risk Factors for Prolonged Intertwin Delivery Interval and Associated Maternal and Second Twin Morbidity"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2327-3402","authenticated-orcid":false,"given":"Naphtali","family":"Justman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roee","family":"Goldfreind","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiba","family":"Abu-Rass","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoav","family":"Siegler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilad","family":"Shahak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Wolfovitz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuval","family":"Ginsberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"},{"name":"Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaniv","family":"Zipori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"},{"name":"Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nizar","family":"Khatib","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"},{"name":"Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeev","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"},{"name":"Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Vitner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel"},{"name":"Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1097\/00003081-200403000-00025","article-title":"Intrapartum management of twins","volume":"47","author":"C 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