{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:50:38Z","timestamp":1771548638987,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,11,2]],"date-time":"2017-11-02T00:00:00Z","timestamp":1509580800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To examine the effect of inter\u2010twin delivery interval on umbilical artery <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> and Apgar score of the second twin after vaginal delivery of the first twin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective study conducted at a single teaching hospital. All pregnant women with twin gestation who delivered the first twin vaginally at more than 24\u00a0weeks between 1995 and 2015 were included. Major malformations and intrauterine deaths of one or both twins were excluded. Women were divided into those who had an inter\u2010twin delivery interval of less than 30 minutes (group 1) or 30 minutes or more (group 2). Primary outcome was umbilical artery pH less than 7.1 and\/or Apgar score less than 7 at 5\u00a0minutes of the second twin. Generalized linear regression with log was performed to evaluate the association with delivery interval.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 88\u00a0145 deliveries during this period, 1955 (2.2%) were twins. Overall, 713 twin pregnancies, 596 (83.6%) in group 1 and 117 (16.4%) in group 2, were eligible and included. Mean inter\u2010delivery interval was 11.0\u00a0\u00b1\u00a06.5 and 52.5\u00a0\u00b1\u00a031.5\u00a0minutes in groups 1 and 2, respectively. After adjusting for variables found significantly different between the groups in univariate analysis, inter\u2010delivery interval of less than 30 minutes or 30 minutes or more was not a significant risk factor for pH less than 7.1 and\/or Apgar less than 7 (<jats:italic>P\u00a0<\/jats:italic>=\u00a0.91). The cesarean rate for delivery of the second twin after vaginal delivery of the first twin was 4.3% overall, with a higher rate among group 2 compared with group 1 (18.2% and 3.2%, respectively; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The second twin's Apgar score and cord artery <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> are probably not affected when the inter\u2010twin delivery interval exceeds 30\u00a0minutes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12317","type":"journal-article","created":{"date-parts":[[2017,11,2]],"date-time":"2017-11-02T08:54:37Z","timestamp":1509612877000},"page":"37-42","source":"Crossref","is-referenced-by-count":15,"title":["Effect of inter\u2010twin delivery interval on umbilical artery pH and Apgar score in the second twin"],"prefix":"10.1111","volume":"45","author":[{"given":"Alon","family":"Tal","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center  Afula Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadar","family":"Peretz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center  Afula Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gali","family":"Garmi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center  Afula Israel"},{"name":"Rappaport Faculty of Medicine Technion  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noah","family":"Zafran","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center  Afula Israel"},{"name":"Rappaport Faculty of Medicine Technion  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shabtai","family":"Romano","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center  Afula Israel"},{"name":"Rappaport Faculty of Medicine Technion  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3603-8452","authenticated-orcid":false,"given":"Raed","family":"Salim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Emek Medical Center  Afula Israel"},{"name":"Rappaport Faculty of Medicine Technion  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2013.12.008"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214939"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7371.1004"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340801934276"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"248","DOI":"10.3346\/jkms.2007.22.2.248","article-title":"Relationship between twin\u2010to\u2010twin delivery interval and umbilical artery acid\u2010base status in the second twin","volume":"22","author":"Sho YH","year":"2007","journal-title":"J Korean Med 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