{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T01:24:29Z","timestamp":1771550669323,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":1035,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2008,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background<\/jats:italic>. Following vaginal delivery of the first twin, the further management to deliver the second twin is in dispute. Controversial discussions have taken place on the importance of the time interval between the birth of the first and the second twin. <jats:italic>Objective<\/jats:italic>. To evaluate factors influencing twin\u2010to\u2010twin delivery time interval, and short\u2010term outcome of the second twin in a complete population\u2010based cohort in Hesse, Germany. <jats:italic>Study design<\/jats:italic>. In a population\u2010based cohort study, between January 1990 and December 2004, all twin pregnancies of \u226534+0 weeks\u2019 gestation with a vaginally delivered first twin were evaluated. Pregnancies with intrauterine death of either one of the twins before the onset of labour, complicated by twin\u2013twin transfusion or fetal malformations were excluded. Some 4,110 twin pregnancies were analysed. Maternal and fetal characteristics for an increased twin\u2010to\u2010twin delivery time interval and its impact on an adverse short\u2010term neonatal outcome, and the effect of the twin\u2010to\u2010twin delivery interval on umbilical arterial pH and base excess of the second twin have been investigated. <jats:italic>Results<\/jats:italic>. In univariate analysis, breech, transverse lie, birth weight discordance with the second twin \u226520% larger, fetal distress, vaginal operative delivery, and caesarean section were associated with an increased time interval. Maternal characteristics were not related to an increased time interval. Increasing time interval was related to a decline in the mean umbilical arterial pH and base excess, and fetal acidosis, Apgar score &lt;7 after 1, 5 and 10 min. In multivariate analysis, birth weight discordance, mode of delivery, and twin\u2010to\u2010twin delivery time interval were associated with an adverse short\u2010term outcome of the second twin. <jats:italic>Conclusion<\/jats:italic>. As twin\u2010to\u2010twin delivery time interval seems to be an independent risk factor for adverse short\u2010term outcome of the second twin, it should be kept short.<\/jats:p>","DOI":"10.1080\/00016340801934276","type":"journal-article","created":{"date-parts":[[2008,2,28]],"date-time":"2008-02-28T19:29:23Z","timestamp":1204226963000},"page":"346-353","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Twin\u2010to\u2010twin delivery time interval: influencing factors and effect on short\u2010term outcome of the second 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