Seasonal variation in human births

During the first half of this century, the seasonal pattern of births in European countries showed a major peak in the spring and a minor peak in the autumn. In contrast, the pattern in the US was of a minor peak in spring and a major peak in autumn. Over the last 20 years, the pattern in England and Wales has changed to resemble the US pattern, and the same seems to be true of several other European countries. A hypothesis is offered to account for the difference between the European and the US patterns and for the change from one to the other in some countries. The magnitude of seasonality correlates positively with latitude: it is suggested that this is partially consequent on variation in luminosity.     

Seasonal variation of births in rural West Bengal: magnitude, direction and correlates

This paper examines seasonal variation of births in a rural community of West Bengal, India, by exploring data from the 1992-93 National Family Health Survey. Suitable time series analyses were used to determine the seasonal pattern of births and to estimate peaks. The trigonometric regression technique was used to carry out this objective. The study attempted to link the results of the regression analysis to the atmospheric temperature of the region during 1987-91, the distribution of respondents' husbands' occupations and the marriage pattern of the community. It was found that, in the study population, conceptions were numerous in the first quarter of a calendar year and the distribution of conceptions over calendar months was negatively associated with the average monthly temperature. In addition, the marriage pattern of the community and the occupational distribution of the fathers also had a significant effect on the distribution of births over calendar months. It is hoped that the findings will boost the development of needs-based maternal and child health (MCH) and family planning programmes in the community.     

Neural tube defects among twin births.

To obtain accurate, unbiased rates of neural tube defects (NTDs) in twins, we conducted a population-based study that included live births and fetal deaths in Los Angeles County, California, ascertaining cases by multiple methods. Twenty-eight twin cases yielded a prevalence-at-birth of 1.6/1,000 twin births, which is significantly higher than the singleton prevalence of 1.1/1,000 births. In twins compared with singletons, the prevalences of both encephalocele and anencephaly are increased, whereas spina bifida is decreased. The twin case male/female sex ratio (.55) is lower than the singleton case sex ratio (.77). Concordance is relatively low at 3.7%, but appears to be higher than recently reported recurrence risks in other low prevalence areas. Stillbirths were most common among female cases and like-sex twins. Our study tends to support proposed etiologic theories associating NTDs with females or monozygotic twins, or both. There is increasing evidence that the etiology of NTDs may differ in high and low prevalence areas. We suggest also that twins and singletons may differ in their response to etiologic factors. The variations among anencephaly, spina bifida, and encephalocele in their association with twinning suggest that there may be different factors that influence the development of each specific NTD. The noted differences among the malformations also indicate that some of the variation among results of other studies of NTDs and twinning may be due to case ascertainment. Including spina bifida cases would decrease the proportion of twins in a study population, while including anencephalics would increase the proportion. Importantly, ascertaining fetal deaths would increase the proportion of anencephalics and case females, so studies of NTDs that do not include fetal deaths will show fewer twins than expected. On the basis of our findings and those of Layde et al., excluding encephaloceles will also decrease the number of twins among NTD cases. When investigating etiologic hypotheses for NTDs, these potential biases must be recognized.     

Seasonal variation of births in Greece. Temporal changes and regional differences over a 24-year period

The seasonal variation of birth rates in Greece was studied for the years 1956-1979. The relatively constant pattern of the period 1956-1974 (with peak in January and February) turned abruptly into a new one (peak in May-July) for the following years. Whereas the seasonal variation of the first period could be explained as an effect of sociocultural (religious) factors on the rate of conceptions, no explanation was found for its change or for the new pattern. Regional differences between NW and SE Greece were also studied. Seasonal factors and their changes were almost similar in both regions.     

Box-Jenkins modeling of chronological series of twin births and single births

A time-series analysis by Box-Jenkins modeling of the monthly observations of twin births and singleton births was attempted. The study is population based. The single-birth series has been matched to the twin-birth series for maternal birth cohort, parity of the twin birth, and residence of the parents. Three-hundred forty-one twin pairs and 340 singleton births were grouped into chronological series spanning 72 months of observation. Univariate and bivariate time-series analyses were used. Box-Jenkins modeling shows that both series share the same basic demographic and reproductive risk factors, such as ovulation and conception rates, abortions, sexual intercourse, and the less well-known random events that determine the time of delivery. These factors are randomly related to both birth processes but exert a more important influence on twin births. Beyond these crude features, twin- and single-birth series differ by the frequency of their seasonal cycle. Twin births show low-frequency variations because of a rather limited number of factors that impinge markedly on the twinning process. Single births are subjected to higher frequency variations that can be ascribed to a greater number of structuring factors, the action of which is less pervasive. Only the January peak is common to both types of births. Aside from the common features, the bivariate analysis shows that both series of births are independent, neither being related to the other. It is concluded that the subtle structuring of both processes is largely distinct. The large fraction of the unaccounted variation of each birth process (about 70%) suggests that most of the variation is due to as yet unidentified factors. The search for environmental and geocosmic factors at the origin of conception and confinement should be considered in future undertakings.     

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     

Seasonal distribution of psychiatric births in England

There is general consensus that season of birth influences the risk of developing psychiatric conditions later in life. We aimed to investigate whether the risk of schizophrenia (SC), bipolar affective disorder (BAD) and recurrent depressive disorder (RDD) is influenced by month of birth in England to a similar extent as other countries using the largest cohort of English patients collected to date (n = 57,971). When cases were compared to the general English population (n = 29,183,034) all diseases showed a seasonal distribution of births (SC p = 2.48E-05; BAD p = 0.019; RDD p = 0.015). This data has implications for future strategies of disease prevention.     

Seasonal variation in arterial blood pressure.

Blood pressure measurements recorded during the medical Research Council''s treatment trial for mild hypertension have been analysed according to the calendar month in which the readings were made. For each age, sex, and treatment group systolic and diastolic pressures were higher in winter than in summer. The seasonal variation in blood pressure was greater in older than in younger subjects and was highly significantly related to maximum and minimum daily air temperature measurements but not to rainfall.     

Setting implementation research priorities to reduce preterm births and stillbirths at the community level

Asha George and colleagues from the GAPPS group report the implementation research priorities to address prematurity and stillbirths at the community level that resulted from their recent expert consensus exercise.     

A decrease in twin births and factors involved in multiple pregnancy]

The object of this investigation were the causes of the decrease of the frequency of twin births during the last two decades. In Moscow this frequency decreased from 1,19% in 1956 to 0,7% in 1973. Among the births the proportion of first births was observed to increase, as well as the proportion of very young mothers. The effect of this process on the women characterized by a tendency to polyembryony was more conspicuous, than in the average on the population as a whole. During the last decades the process of acceleration of puberty was observed both in the mothers of twins and in all the women in general. However a somewhat later onset of first menstruations is characteristic of the women having a tendency to polyembryony-Hormonal changes taking place in the course of acceleration are apparently one of the causes of the decrease of the twin births frequency.     

Demographic analysis of the variation in the rates of multiple maternities in Sweden since 1751

To elucidate the causes and mechanisms of twinning and higher multifetal maternities, we have taken advantage of the statistical sources of Sweden, where continuous statistics for the whole population are the oldest available. We found strong secular and regional fluctuations. The rates of multiple maternities were the highest during the last three decades of the 18th century, when the twinning rate was more than 17 per 1,000, the triplet rate was more than 3 per 10,000, and the quadruplet rate was almost 7 per 1 million maternities. During 1849-1873 the twinning rate in Sweden was 14.2 per 1,000, but this rate showed great regional differences, being 18.0 per 1,000 on the island of Gotland and 12.6 per 1,000 in the county of Alvsborg. During this period the twinning rate in the countryside in the county of Stockholm was 20.4, but in the city of Stockholm it was only 14.1 per 1,000. In Sweden after the 1930s there was a marked decrease in the twinning rate, which by the 1960s had fallen to only about half of what it had been two centuries earlier. The corresponding reductions for triplet and quadruplet rates were about 75%. The aim of this paper was to study the temporal and regional variations in multiple maternities in Sweden from 1751 to 1960 based on demographic and some socioeconomic data for the counties. We confirmed our earlier studies that maternal age and parity cannot satisfactorily explain the secular and regional differences in the twinning rates. In contrast to studies in France (1901-1968), we found no unequivocal association between the twinning rates and the crude birth rates. The correlation coefficients between the twinning rate and the crude birth rate showed statistically significant regional and temporal variations. After eliminating the temporal trends, regional differences in the correlation coefficients remained. The twinning rates for the counties seem to converge toward a common low level, 10-12 per 1,000. The observed convergence toward relatively similar levels may be caused by the increased matrimonial migration distances and decreased endogamy of the citizens as a consequence of better communications. The increased urbanization and industrialization that started in the last decades of the 19th century broke up the old static agrarian isolates and caused Sweden, within 2-3 generations, to develop from a poor nation to one of the most prosperous in the world. A more urban and affluent lifestyle, a better diet, and increased stress and sedentary occupations may have reduced the physical capacity of mothers to carry gestations with multiple embryos or fetuses to completion.     

Frequency of twin births among Holstein-Friesian cows in a warm dry climate

The objectives of this study were to examine 1) the effect of parity of dam and season of birth on the incidence of twins in Holstein-Friesian cattle in a warm, dry climate and 2) the sex ratio, gestation period and birth weight of calves born. Natural calvings (n = 24,843) from nine dairy farms in Saudi Arabia were evaluated over an 8-year period. The calendar year was divided into six bimonthly intervals to identify a possible seasonal effect on the number of natural twins born (twinning rate). The twinning rate increased (P < 0.05) from 1.0% (103 10,094 ) at first calving to 8.0% (1,178 14,749 ) for all the subsequent calvings. The twinning rate was similar with the second calving (P(2)) at 7.0% (417 5,929 ), the third calving (P(3)) at 7.5% (218 2,896 ), and the fourth calving (P(4)) at 7.8% (147 1,864 ). Correspondingly, cows having >/= five calves had a higher (P < 0.01) twinning rate at 9.0% (164 1,805 ) than cows with too, three or four calvings collectively at 7.3% (782 10,689 ). The seasonal effect on twinning rate was significant within all parity calvings except in primiparous females. The peak twinning rate occurred in the third season interval (May/June) at 9.3% (66 708 ) with P(2), at 13.0% (34 262 ) with P(3), at 13.8% (27 196 ) with P(4), and at 12.5% (23 184 ) with P(5) females. The male to female ratio was different (P < 0.01) for multiparous females (55:46; n = 12,305). The ratio of males to females (55:45) was also different (P < 0.01) for all twin pairs (n = 1,151), evaluated in the study. The gestation period for cows with single calves was 8.5 days longer (P < 0.05) than that of cows carrying twin calves. The birth weight of single calves was 13.1 kg greater (P < 0.05) than that of twin calves. The reason for the marked increase in the twinning rate during the warmest months may be explained by greater embryo mortality in the hot vs cool months.