Outcomes of Multiplets

Shinwell, ES; Haklai, T.; Eventov‐Friedman, Smadar

doi:10.1159/000151750

Cited by 47 publications

(41 citation statements)

References 136 publications

(70 reference statements)

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“…However, previous studies have suggested that twins had lower risk for cancers of the lung (20, 48, 49), skin (20), colon, and rectum (18, 20, 48). Thus, it does not seem likely that the average lower birth weight and gestational age for twins (50, 51) compared with singletons influence cancer risk, which has also been supported in previous studies (52–54). …”

Section: Discussionsupporting

confidence: 73%

Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden

Ahrenfeldt

Skytthe

Möller

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Increasing evidence shows that some cancers originate in utero. It is hypothesized that elevated exposure to some steroid hormones might increase cancer risk and that hormone transfer between twin fetuses could result in different prenatal exposure to testosterone. Methods This large-scale prospective twin study compared opposite-sex (OS) and same-sex (SS) twins to test the impact of intrauterine exposures on cancer risk. On the basis of the Danish and Swedish twin and cancer registries, we calculated incidence rate ratios for OS and SS twins, whereas standardized incidence ratios (SIR) with 95% confidence intervals (CI) were calculated for OS/SS twins compared with the general population. Results Atotal of 18,001 cancers were identified during 1943–2009. No significant differences were observed between OS and SS twins, neither for the sex-specific cancers nor for cancer at all sites. All-cause cancer was slightly reduced for OS and SS twins compared with the general population, significant for OS males (SIR, 0.95; 95% CI, 0.92–0.98) and for SS males and females (SIR, 0.97; 95% CI, 0.94–0.99). Conclusions Our data suggest that having a male co-twin—which may entail higher exposure to prenatal testosterone—does not increase the risk of sex-specific cancers in OS females. Furthermore, the study supports that twinning per se is not a risk factor of cancer. Impact Findings are reassuring, as they fail to provide evidence for the hypothesis that endocrine or other difference in the in utero milieu affects the risk of sex-specific cancers.

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Section: Discussionsupporting

confidence: 73%

Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden

Ahrenfeldt

Skytthe

Möller

et al. 2015

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Compared to singletons or twins, triplets are delayed in growth and cognitive development. There has been limited research on the effects of BW discordance, but it seems that triplets who are discordant in BW are at an even higher developmental risk than other triplets [43,44]. One study found that most triplets without BW discordance have caught up with singleton and twin standards on cognitive and executive functions at age 5.…”

Section: Discussionmentioning

confidence: 99%

Birth weight in a large series of triplets

et al. 2011

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BackgroundTriplets are often born premature and with a low birth weight. Because the incidence of triplet births is rare, there are relatively few studies describing triplet birth weight characteristics. Earlier studies are often characterized by small sample sizes and lack information on important background variables such as zygosity. The objective of this study is to examine factors associated with birth weight in a large, population-based sample of triplets registered with the Netherlands Twin Register (NTR).MethodsIn a sample of 1230 triplets from 410 families, the effects of assisted reproductive techniques, zygosity, birth order, gestational age, sex, maternal smoking and alcohol consumption during pregnancy on birth weight were assessed. The resemblance among triplets for birth weight was estimated as a function of zygosity. Birth weight discordance within families was studied by the pair-wise difference between triplets, expressed as a percentage of the birth weight of the heaviest child. We compare data from triplets registered with the NTR with data from population records, which include live births, stillbirths and children that have deceased within days after birth.ResultsThere was no effect of assisted reproductive techniques on triplet birth weight. At gestational age 24 to 40 weeks triplets gained on average 130 grams per week; boys weighed 110 grams more than girls and triplets of smoking mothers weighted 104 grams less than children of non-smoking mothers. Monozygotic triplets had lower birth weights than di- and trizygotic triplets and birth weight discordance was smaller in monozygotic triplets than in di- and trizygotic triplets. The correlation in birth weight among monozygotic and dizygotic triplets was 0.42 and 0.32, respectively. In nearly two-thirds of the families, the heaviest and the lightest triplet had a birth weight discordance over 15%. The NTR sample is representative for the Dutch triplet population that is still alive 28 days after birth.ConclusionBirth weight is an important determinant of childhood development. Triplet status, gestational age, sex, zygosity and maternal smoking affect birth weight. The combined effects amount to a difference of 364 grams between monozygotic girl triplets of smoking mothers compared to dizygotic boy triplets of non-smoking mothers of the same gestational age. Birth weight in triplets is also influenced by genetic factors, as indicated by a larger correlation in monozygotic than in di- and trizygotic triplets.

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“…3,4 Nevertheless, knowledge about the well-being, the socio-emotional and behavioral functioning of triplets is quite scarce. 5 While we could not find any study on triplets' HRQoL, there are two longitudinal cohort studies reporting behavioral adjustment of triplets. These studies demonstrated that behavioral problems are reported for early ages (2 years), but improve thereafter.…”

Section: Introductionmentioning

confidence: 81%

Health-Related Quality of Life and Behavior of Triplets at Adolescent Age

Natalucci

Iten

Hofmann

et al. 2012

The Journal of Pediatrics

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OBJECTIVES: To assess health-related quality of life (HRQoL) and behavior of triplets compared with matched singletons at adolescent age and to identify medical and sociodemographic predictors of outcome. STUDY DESIGN: Fifty-four triplets (19 sets, mean [SD] gestational age 32.0 [2.4] weeks, birth weight 1580 [450] g) and 51 gestational age-, birth weight-, and sex-matched singleton controls self-rated their HRQoL at age 14.5 (0.3) years. Proxy reports about HRQoL and behavior were obtained by parents and teachers. HRQoL was measured with the Kidscreen-52 questionnaire child and parent form, and behavior with the Achenbach Child Behavior Checklist. RESULTS: Self-and parentreported HRQoL values was similar in both groups except for the dimensions "mood and emotions" and "autonomy," which were better (P = .001, P = .03) in triplets. Parents reported significantly less behavioral problems in triplets compared with controls. Compared with community norms, both HRQoL and behavior measures in triplets were in the normal range. Parent-reported HRQoL was predicted by dichorionicity. CONCLUSIONS: HRQoL and behavioral outcome in adolescent triplets was good in our study and was, in some aspects, better than in matched singleton controls. Dichorionicity is an important outcome determinant.

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Outcomes of Multiplets

Cited by 47 publications

References 136 publications

Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden

Risk of Sex-Specific Cancers in Opposite-Sex and Same-Sex Twins in Denmark and Sweden

Birth weight in a large series of triplets

Health-Related Quality of Life and Behavior of Triplets at Adolescent Age

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