Lack of effect of maternal body mass index on anthropometric characteristics of newborns in twin gestations

We examined the correlation between maternal prepregnancy body mass index (BMI) and newborn weight, length, BMI, and gestational order, in singleton and twin births. The sample comprised 381 mothers of multiple babies (562 twins), and 7979 singleton pregnancies, used as controls. The Mann-Whitney non-parametric test was used to compare the values between the two groups, and the Spearman's correlation test (rS) was applied to the quantitative variables. A significant positive correlation was found with singleton baby variables: the higher the maternal BMI, the higher the newborn's BMI, weight, length, and gestational order. However, no significant correlation was found between maternal BMI and any of these variables in twins. Maternal weight gain, in the twin group, showed a significant positive correlation with the newborn gestational order (rS = 0.154; P = 0.002), weight (rS = 0.493; P < 0.001), length (rS = 0.469; P < 0.001), and BMI (rS = 0.418; P < 0.001). In singletons, the correlation was positive with all the variables, except for the gestational order. The newborn BMI was significantly higher in twins born by C-section than those born by vaginal birth (Z = -4.974; P < 0.001). Mothers of singletons delivered by C-section had a significantly higher BMI than those of singletons born by vaginal birth (Z = -1.642; P < 0.001); however, no significant differences were observed in mothers of twins. Prepregnancy maternal BMI in twin births would not be predictive of newborns weight, length and BMI in this population. Maternal weight gain during pregnancy proved to be the most adequate for predicting the weight, length and BMI of twins delivered by C-section.     

Etiology of individual differences in birth weight of twins as a function of maternal smoking during pregnancy.

Birth weight is in large extent influenced by gestational age. In addition genetic and environmental factors determine intrauterine growth and birth weight. The contributions of these factors may be influenced by maternal smoking during pregnancy. We examined birth weight and maternal smoking in a sample of 2930 twin pairs from the Netherlands Twin Register using structural equation modelling. Gestational age accounted for 27-44% of the variance in birth weight. A lower variability of birth weight and a lower association of birth weight with gestational age was found in twins whose mothers smoked during pregnancy. The variance not associated with gestational age was independent of maternal smoking during pregnancy. A systematic smaller part of the variability in birth weight was associated with variability in gestational age in second born twins compared to first born twins. The heritability of interindividual differences in birth weight was modest (10% for twins with non-smoking mothers and 11% for twins with smoking mothers). Common environmental influences other than gestational age accounted for a slightly larger part of the variance not associated with gestational age (17-20%).     

大熊猫双胞胎生长发育影响因素的研究

为了研究影响大熊猫Ailuropoda melanoleuca双胞胎生长发育的因素,以2013—2016年成都大熊猫繁育研究基地出生的22对大熊猫双胞胎幼仔及其母兽为研究对象,分析母兽孕期增重、双胞胎个体性别和双胞胎性别类型与大熊猫双胞胎幼仔初生体质量之间的关系,以及双胞胎个体性别和大熊猫幼仔初生体质量与1~12月龄大熊猫幼仔体质量之间的关系。结果显示,不同双胞胎性别类型的大熊猫幼仔初生体质量的差异有统计学意义(P=0.015),但母兽孕期增重、双胞胎个体性别与幼仔初生体质量的差异无统计学意义(P=0.257、P=0.170);双胞胎2只个体的初生体质量不同(χ^2=9.043,P=0.041),且双胞胎性别类型与幼仔初生体质量差异程度呈中等强度相关(Cramer s V=0.492,P=0.030),双雌性双胞胎初生体质量差异为20%~40%(调整后标化残差:2.30),双雄性双胞胎初生体质量差异小于20%(调整后标化残差:2.60);双胞胎个体性别和初生体质量对1~12月龄大熊猫幼仔生长发育的影响无统计学意义(P>0.05)。对大熊猫双胞胎幼仔生长发育影响因素的研究,为大熊猫双胞胎的饲养管理提供理论依据。     

Impact of maternal age on birth outcomes: a population-based study of primiparous Brazilian women in the city of São Paulo

The aim of this study is to analyse the impact of maternal age at first birth on low birth weight, preterm birth and low Apgar scores at one minute and at five minutes among live births delivered to primiparous Brazilian women in the city of S?o Paulo. Analyses were based on 73,820 birth records from the 1998 birth cohort. Logistic regression was used to assess the association between maternal age and each outcome variable, controlling for the following risk factors: delivery mode, plurality, sex, maternal education, number of prior losses, prenatal care, race, parity and community development. Maternal ages below 20 and above 30 years were significantly associated with the risks of low birth weight and preterm birth, but no association was found between maternal ages and Apgar score, with the exception that ages 15-19 reduced the odds of a low one-minute score. Even though this result seems to be inconsistent, low birth weight, preterm birth and low Apgar scores measure different dimensions of newborn well-being, and the association of each measure with maternal age is expected to diverge.     

Maternal behavior toward premature twins: implications for development.

Assisted reproductive techniques and fertility enhancing therapies have increased multiple births and, therefore, the risk of prematurity and its developmental consequences. Parent intervention is an effective source of compensation for the cognitive effects of prematurity. We hypothesized that relative to parents of preterm singletons, parents of preterm twins are less able to provide such enhancing care, resulting in a developmental disadvantage for preterm twins. Maternal-infant interactions of premature singletons (n = 22; birth weight = 1668 +/- 350 g, gestational age = 32.3 +/- 2.1 weeks) and premature twins (n = 8; birth weight = 1618 +/- 249 g; gestational age = 32.0 +/- 2.6 weeks) with comparable demographic and medical status were observed at home at 1 and 8 months corrected age using a 30 min checklist of developmentally facilitative behavior. Mental (MDI) and psychomotor (PDI) indices of the Bayley Scales of Infant Development and Caldwell Home Observations for Measurement of the Environment (HOME) inventories were administered (18 months corrected age). Compared with mothers of premature singletons, mothers of premature twins exhibited fewer initiatives (P < 0.001) and responses (P < 0.01) and were less responsive to positive signals (P < 0.01) and crying (P < 0.01). Unprompted by the infant, twin mothers lifted or held (P < 0.05), touched (P < 0.01), patted (P < 0.05) or talked (P < 0.01) less. Singleton MDIs surpassed twins (119.4 +/- 7.7 vs 103.6 +/- 7.7; P < 0.01). Maternal verbal behavior and the acceptance of child factor (HOME), both favoring singletons, correlated with MDI (R-square = 0.46, P < 0.0002). Mothers of premature twins exhibited fewer initiatives and responses toward offspring than did mothers of premature singletons. Maternal behavior was predictive of cognitive development.     

Perinatal mortality in term and preterm twin and singleton births.

Although, in general, twins have higher perinatal mortality rates than singletons, preterm twins have lower perinatal mortality rates than singletons of the same birth weight or gestational age. This study investigated the hypotheses that this paradoxical twin advantage: 1) is due to gestational age distribution differences between the singleton and twin populations, and 2) is due to increased likelihood of birth having occurred in a tertiary perinatal center. A pre-existing, time-limited data set of all births in the province of Ontario in odd years between 1979 and 1985 was chosen for this study because of the large sample size (n = 618,579). Multivariable logistic regression of the relationship between perinatal mortality and twin status was controlled for mother's age, hospital level and gestational age. Findings confirm the lower mortality of preterm twins. After controlling for level of hospital of birth this difference remained, suggesting that level of hospital of birth was not a major factor responsible for the twin advantage. Analyses in which gestational age was standardized indicate that, for those whose gestational age was less than 2 SD below the mean for their particular group (twin or singleton), twins were actually at higher risk than singletons. These results support hypothesis 1 and do not strongly support hypothesis 2. The results also support earlier authors' suggestions that the definition of term birth should be different for twins and singletons     

Potential bias regarding birth weight in historical and contemporary twin data bases.

In this study we examine the hypothesis that monozygotic (MZ) twins in historical databases are less discordant for birth weight due to negative selection of severely discordant MZ twins. Furthermore, we test the hypothesis that MZ twins are less discordant for birth weight when comparing a volunteer based twin registry with a population based twin registry, due to selective registration. Data were available on 3927 twin pairs from the volunteer Australian Twin Registry born before 1964, 3059 volunteer twin pairs from the Netherlands Twin Register born 1987-1989 and 454 Belgian twin pairs from The East Flanders Prospective Twin Survey born 1987-1989. Intrapair relative birth weight differences (RBWD) were computed for MZ and dizygotic (DZ) twins from each twin registry. Comparing birth weight differences between MZ and DZ twins provides support for the hypothesis that MZ twins are subject to a negative selection in historical databases. Furthermore, Australian MZ twins have a lower RBWD compared to Dutch MZ twins when corrected for the RBWD of Australian and Dutch DZ twins, indicating circumstances which only affect MZ twins. Our hypothesis that MZ twins are less discordant for birth weight in a volunteer based twin registry compared to a population based twin registry had to be rejected. We suggest that investigators using historical databases to test the fetal origins hypothesis should be aware of this increased likelihood of selective exclusion of individuals with extreme morphometric parameters at time of birth.     

A Conversation with Bakhtin : On Inquiry and Dialogic Thinking

Two different traditions in psychology emphasize the study of twin-twin and mother-twin relationships. One line of research, the twin development approach, has compared parenting styles and sibling relationships in families with twin and singleton offspring. This research tradition is based on the assumption that twins, relative to singletons, may be at risk for developmental delays in motor, cognitive [1-3], linguistic [1,4,5], and social-emotional functioning [6,7] because of their increased rate of prematurity, lower birth weight [8-11], increased parenting demands that result in less interactive maternal speech [12-18], shared peer time [19], and other experiences that distinguish twins from singletons [7,8,19-21]. Although recent studies have not replicated the developmental concerns [22-26] or concerns about specific birth defects [27] that emerged from earlier studies comparing twins and singletons, there continues to be interest in the relational differences that may be present in twin and singleton families and in the need to address educational and social policies that promote twin development [28,29]. Within the framework of this approach, distinctions between twins and singletons have received more attention than distinctions between fraternal, dizygotic (DZ) and identical, monozygotic (MZ) twins.     

Genetic and environmental influences on expression of recurrent headache as a function of the reporting age in twins.

To explore age-related mechanisms in the expression of recurrent headache, we evaluated whether genetic and environmental influences are a function of the reporting age using questionnaire information that was gathered in 1973 for 15- to 47-year-old Swedish twins (n = 12,606 twin pairs). Liability to mixed headache (mild migraine and tension-type headache) was explained by non-additive genetic influences (49%) in men aged from 15 to 30 years and additive genetic plus shared environmental influences (28%) in men aged from 31 to 47 years. In women, the explained proportion of variance, which was mainly due to additive genetic effects, ranged from 61% in adolescent twins to 12% in twins aged from 41 to 47 years, whereas individual specific environmental variance was significantly lower in twins aged from 15 to 20 years than in twins aged from 21 to 30 years. Liability to migrainous headache (more severe migraine) was explained by non-additive genetic influences in men, 32% in young men and 45% in old men, while total phenotypic variance was significantly lower in young men than in old men. In women, the explained proportion of variance ranged from 91% in the youngest age group to 37% in the oldest age group, with major contributions from non-additive effects in young and old women (15-20 years and 41-47 years, respectively) and additive genetic effects in intermediate age groups (21-40 years). While total variance showed a positive age trend, genetic variance tended to be stable across age groups, whereas individual specific environmental variance was significantly lower in adolescent women as compared to older women.     

Twin and singleton births in Ghana--a case-control study.

A retrospective study involving 623 twin and 1246 singleton births was conducted to compare the two groups with regard to selected maternal, fetal and labor and delivery characteristics and outcomes. Maternal age and parity were significantly higher for twins. The risks of preterm delivery, arrival in the labor ward in second stage of labor, cesarean births and postpartum haemorrhage were significantly higher in twin than in singleton births. In vaginal deliveries twin mothers were significantly less likely to have had episiotomies or perineal lacerations. There was no difference in the duration of the third stage of labor or in the incidence of retained placentae. Antepartum haemorrhage was a less likely indication for cesarean delivery among twins, while there was no significant difference in the likelihood of severe pre-eclampsia/eclampsia being an indication. Singleton babies were significantly heavier than twins. The incidences of malpresentation, low birth weight, stillbirths and of admission of live births to the neonatal intensive care unit were significantly higher in twins. There was no difference in the rate of instrumental vaginal delivery, or in the route of delivery of fetuses presenting by the breech. There is the need for detailed study of the incidences of antepartum haemorrhage and hypertensive diseases in twin and singleton pregnancies and of the factors determining the mode of delivery when such complications arise. Labor and delivery should also be examined to determine any differences between the two groups, especially in the first and second stages.     

Proportion of low birth weight infants in Visakhapatnam (India) and its relationship with maternal age, parity and infants survival

The percentage of low birth weight infants (LBWI) weighing less than 2270 g in Visakhapatnam (Andhra Pradesh) is relatively higher (12.8%) than in other parts of India. The frequency of LBWI is high at birth order 1 and 2. Thereafter the curve does not show any consistency although the mean per cent of LBWI is lesser than in birth order 1 and 2. The minimum frequency is at birth order 3. The maternal classes less than or equal to 20-29 years show a gradual decrease in the frequency of LBWI with increasing age. For mothers of greater than or equal to 30-39 years of age a general U-shaped relation is found. The overall distribution of neonatal deaths is bimodal, with a peak at less than 1350 g and at 1810 g.     

Genetic and Environmental Influences on the Tracking of Body Size from Birth to Early Adulthood

Objective: This study identified genetic and environmental influences on the tracking of body size from birth to 16 to 18.5 years of age. Research Methods and Procedures: Longitudinal information was collected from a nationally representative sample of Finnish twin adolescents (birth cohorts 1975 to 1979) and their parents through questionnaires mailed when the twins were ages 16 and 18.5 years old. The sample included 702 monozygotic, 724 same‐sex dizygotic, and 762 opposite‐sex dizygotic sets of twins. The measures used were length, weight, ponderal index (kilograms per cubic meters), and gestational age at birth, and height, weight, and body mass index (kilograms per square meters) at 16 to 18.5 years of age. The changes in genetic and environmental influences on body size from birth to early adulthood were analyzed by quantitative genetic modeling. Results: The twins who had a higher weight or ponderal index at birth were taller and heavier in early adulthood, whereas those who were longer at birth were taller, but not heavier, later in life. Adult height was affected more by the birth size than body mass index. In the genetic modeling analyses, the genetic factors accounting for the variation of body size became more apparent with age, and both genetic and environmental influences on stature had a sizable carry‐over effect from birth to late adolescence, whereas for relative weight, the influences were more age‐specific. Discussion: The genetic and environmental architecture of body size changes from birth to adulthood. Even in monozygotic twins who share their genetic background, the initially larger twin tended to remain larger, demonstrating the long‐lasting effects of fetal environment on final body size.     

Size at birth, fasting glucose and insulin levels and insulin resistance in adult twins.

Studies in singletons have found an association between birthweight and Type 2 diabetes in adult life. The aim of this study was to investigate whether this association could also be seen in twins. 59 monozygotic (MZ) and 69 dizygotic (DZ) same-sex twin pairs aged 19-50 years and 89 singleton controls matched for age, gestational age, gender, maternal age and parity were recruited from a local obstetric database. Associations between adult glucose, HbA(1)C and insulin levels and insulin resistance and birthweight were assessed by linear regression with adjustment for confounding variables. Twins were significantly lighter at birth than singleton controls, but there were no significant differences in adult weight, glucose, HbA(1)C and insulin levels or insulin resistance between twins and controls. The relationship between birthweight and fasting glucose and insulin levels, and insulin resistance was not significantly different from zero in either twins or controls, but birthweight was significantly negatively associated with HbA(1)C only in controls. There was no evidence of a difference between MZ and DZ twins in unpaired or within-pair analysis. These results provide little evidence that low birthweight in twins increases the risk of impaired glucose-insulin metabolism in young adults or that genetic factors can account for the association observed in singletons.     

The outcome of twin pregnancies in mares

Brood-farm veterinarians were surveyed and theriogenology records were examined to obtain information on the natural outcome of rectally-diagnosed twin pregnancies. Four of the veterinarians estimated that 50% of mares with twin embryos had single foals. In the analyses of palpation records, 31 53 (58%) of the diagnosed twin pregnancies terminated in birth of one foal. However, the loss of one embryo without the loss of the other occurred significantly more often before day 40-42 (30 53 ; 57%) than after day 40-42 (1 16 ; 6%). Of the remaining 15 mares with diagnosed twins at day 40-42, 5 had two foals and 10 had no foals. The methods used for intervention when twins were diagnosed were unsatisfactory. Complete termination of pregnancy with a prostaglandin or an intrauterine flushing resulted in failure to reestablish a singleton pregnancy during the operational breeding season in 10 11 mares. Attempts to eliminate one embryo resulted in loss of both in 6 7 mares. The results indicated that, at the present time, nonintervention should be given more consideration as a method of handling twin pregnancies.     

A matched cohort comparison of the outcome of twin versus singleton pregnancies in Flanders, Belgium.

To compare perinatal outcome of singleton versus twin pregnancies a matched cohort study was performed in Flanders, Belgium. All twins delivered in the region of Flanders during 1998-1999 were compared to singletons, matched for gestational age, fetal sex and maternal parity, resulting in 4384 infants in each group. Above 32 weeks of gestation, birthweight was significantly lower in twins (2095 +/- 364 g versus 2315 +/- 523 g; p < 0.001, 95% confidence interval 193 to 246 g). Perinatal mortality was also significantly lower in twins (1.98% versus 1.26%; odds ratio for twins 0.63; 95% confidence interval 0.53-0.75; p < 0.001 ), this was mostly due to fetal and not to early neonatal mortality. Congenital malformations occurred less frequently in twins (2.5% versus 3.7%; odds ratio for twins 0.80, 95% confidence interval 0.69-0.92; p = 0.001). From gestational age of 32 weeks on, respiratory distress syndrome was less frequent in twins (6.7% versus 8.0%; odds ratio for twins 0.81; 95% confidence interval 0.68-0.97; p = 0.011 ). No significant differences were noted with regard to intraventricular haemorrhage, neonatal infections and retinopathy of prematurity. Although twins have a lower birthweight, their outcome is more favorable compared to singletons, when matched for gestational age.     

母亲年龄对中国双生子出生率的影响

选用全国人口普查时登报的 1 989年 1月 1日至 1 2月 31日期间中国育龄妇女 ( 1 5— 49岁 )的生产记录 ,用 Weinberg差别法进行双生子卵性分类 ,分析了中国总体、DZ和 MZ双生子出生率与母亲年龄之间的关系以及双生子的出生性别比。结果表明 ,中国总体、 DZ和 MZ双生子的出生率分别为 0 .787± 0 .0 0 2 % ,0 .573± 0 .0 0 2 %和 0 .2 1 4± 0 .0 0 1 % ,DZ双生子出生率在 33岁前随母亲年龄增高单调上升 ,随后下降 ,但在 46岁后又随龄上升 ,MZ双生子出生率在 34岁前相对恒定 ,随后随龄上升。中国双生子出生性别比显著性低于同期群体出生性别比 ,1 5— 1 9岁和 45— 49岁年龄组出生的双生子性别比低于其它年龄组出生的双生子性别比 ,1 5— 1 9岁和 45— 49岁年龄组出生的双生子性别比较低可能是较低的 MZ双生子出生性别比造成的。     

Predicting time of parturition from changing vaginal temperature measured by data-logging apparatus in beef cows with twin fetuses

Vaginal temperatures (VT) of crossbred (Japanese Black crossed Holstein-Friesian) beef cows (n = 31) were measured by a data-logging apparatus to obtain serial data from days 0 to 6 before parturition. For both single and twin pregnancies, no significant differences were observed in VT during days 3-6 before parturition. Maternal VT was not affected by maternal weight just after parturition, parity, fetal sex, or total fetal litter weight. Average of twin litter weights for two males (MM) and two females (FF) had the strong positive correlations (r = 0.84; P < 0.05) with maternal VT, whereas twin weights of mixed-gender twins (FM) did not correlate with maternal VT (r = -0.26; P = 0.61). Maternal temperature decreased as weights of the female fetus of FM twins became heavier (r = -0.82; P < 0.05). In contrast, maternal VT of FF and MM twins increased as twin weights increased. We defined when the VT began to decrease before parturition by two different methods. One was the "same hours method" where differences in VT between a particular time of day and the corresponding time of the preceding day were compared when the VT was consistently > or =0.3 or > or =0.5 degrees C for more than 3h. The second method was the "maximum-minimum method" where decreased in the maximum or the minimum values of the day over > or =0.3 and > or =0.5 degrees C were compared to values of preceding day. Onset of decreased VT before expulsion was not different between singletons and twins. In an attempt to define the critical condition in predicting parturition, we estimated assumable predicting probability using the 31 cows that were collected VT. When the parturition occurred within 60 h in the "same hours method" and 72 h since VT was > or =0.3 degrees C and in the "maximum-minimum method", the assumable probability was 100%. In verification experiment under these condition, the "same hours method" had a higher probability of predicting the time of parturition than the "maximum-minimum method", and it was possible to detect the onset of decreased VT at the correct time by the minutes. We concluded that "same hours method" was useful for predicting parturition time in cattle with single and twin pregnancies by the serial measurement of vaginal temperature.     

Blood pressure in prospective population based cohort of newborn and infant twins.

OBJECTIVE--To describe blood pressure in twins during infancy. DESIGN--Prospective study of cohort of twins. SETTING--Teaching hospital in Florida. SUBJECTS--166 viable twin pairs born between July 1976 and December 1989. MAIN OUTCOME MEASURES--Blood pressure and body weight at birth, at 14 days, and at 1, 3, 6, 9, and 12 months. RESULTS--Both systolic and diastolic pressure correlated with body weight throughout infancy (at birth r = 0.41, P < 0.001 and r = 0.42, P < 0.001 respectively; at 1 year r = 0.23, P < 0.001 and r = 0.26, P < 0.001 respectively). In infants weighing < 1500 g at birth mean blood pressure rose from about 45/25 mm Hg to 101/55 mm Hg from birth to the age of 1 year, while in infants weighing > 3000 g at birth it rose from 63/39 mm Hg to 100/61 mm Hg; corresponding mean body weights at 1 year were 7.86 kg and 9.88 kg. Differences in birth weight within pairs of monozygotic twins were negatively correlated with such differences in systolic blood pressure at 1 year (r = -0.37, P < 0.01). CONCLUSIONS--Blood pressure and body weights in twins showed strongly positive but generally declining correlations throughout infancy. Twins of lower birth weight showed a more rapid rate of rise in blood pressure during infancy. At 1 year the catch up in blood pressure exceeded that in body weight. Greater differences in birth weights between monozygotic twins were associated with smaller differences in systolic blood pressure at 1 year, suggesting that intrauterine environmental factors related to birth weight are important in determining blood pressure in infancy.