{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:16:19Z","timestamp":1783397779143,"version":"3.54.6"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To compare labour dynamics between nulliparous women with IVF\/ICSI and spontaneous conception, and to assess the effect of epidural analgesia on the timing and incidence of vaginal birth using time\u2010to\u2010event methods.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Matched retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Tertiary referral centre, Bologna, Italy.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n A total of 124 IVF\/ICSI and 248 maternal age\u2013matched spontaneous conceptions undergoing induction of labour at \u2265\u200937\u2009weeks between January 2019 and December 2023.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Time\u2010to\u2010vaginal\u2010delivery patterns were evaluated using smoothed instantaneous hazard (SIH) functions. Caesarean delivery was treated as a competing event, and subhazard ratios (sHR) were estimated using Fine\u2013Grey regression. Analyses were stratified by epidural analgesia and adjusted for cervical dilation at induction, body mass index at term, and induction\u2010related variables.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n Labour dynamics and cumulative incidence of vaginal delivery over time.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 372 inductions, spontaneous conceptions had higher vaginal delivery rates than IVF\/ICSI pregnancies (85.1% vs. 72.6%,\n p<\/jats:italic>\n \u2009=\u20090.005) and shorter active labour (167 vs. 272\u2009min,\n p<\/jats:italic>\n \u2009<\u20090.001). SIH curves showed earlier and more sustained peaks with late\u2010labour rebound in spontaneous conceptions, whereas IVF\/ICSI pregnancies exhibited flatter, persistently lower hazards. IVF\/ICSI conception was associated with a significantly lower cumulative incidence of vaginal birth (sHR 0.67,\n p<\/jats:italic>\n \u2009<\u20090.001). Epidural analgesia delayed the timing but did not reduce the overall likelihood of vaginal delivery in spontaneous conceptions, while no significant effect was observed in IVF\/ICSI pregnancies.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Labour dynamics differ by mode of conception. IVF\/ICSI pregnancies show reduced labour progression and earlier transition to caesarean delivery.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.70300","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T03:36:11Z","timestamp":1783395371000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Labour Dynamics After Induction in Nulliparous IVF\/ICSI and Spontaneous Pregnancies: A Matched Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8959-3583","authenticated-orcid":false,"given":"Anna","family":"Seidenari","sequence":"first","affiliation":[{"name":"Obstetric Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Doroldi","sequence":"additional","affiliation":[{"name":"Obstetric Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cecilia","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Obstetric Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Calisti","sequence":"additional","affiliation":[{"name":"Obstetric Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Sollevanti","sequence":"additional","affiliation":[{"name":"Obstetric Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Scollo","sequence":"additional","affiliation":[{"name":"Obstetric Unit IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Scibilia","sequence":"additional","affiliation":[{"name":"Kore University Medicine and Surgery Enna Italy"},{"name":"Gynecology Unit Giovanni Paolo II Hospital Ragusa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danila","family":"Morano","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Sant'Anna University Hospital Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Farina","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynaecology, Department of Life, Health and Environmental Sciences University of L'Aquila L'Aquila Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"\u201cDeliveries Over Time\u2014NHS England Digital \u201dhttps:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/nhs\u2010maternity\u2010statistics\/2022\u201023\/deliveries\u2010\u2010\u2010time\u2010series."},{"key":"e_1_2_12_3_1","first-page":"1","article-title":"Births in the United States, 2022","volume":"477","author":"Martin J. 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