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The Association of Twinning and Neural Tube Defects: Studies in Los Angeles, California, and Norway

Published online by Cambridge University Press:  01 August 2014

Gayle C. Windham ,
Tor Bjerkedal  and
Lowell E. Sever
Gayle C. Windham*
Affiliation:
Institute of Preventive Medicine, University of Oslo, Los Angeles Division of Epidemiology, School of Public Health, University of California, Los Angeles
Tor Bjerkedal
Affiliation:
Institute of Preventive Medicine, University of Oslo, Los Angeles
Lowell E. Sever*
Affiliation:
Division of Epidemiology, School of Public Health, University of California, Los Angeles
*
National Institute of Public Health, Postuttak Oslo 1, Norway
Battelle Pacific Northwest Laboratories, Richland, WA 99352, USA

Abstract

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Accurate, unbiased malformation rates in twins must be obtained unselectively from population-based studies that include livebirths and stillbirths after a thorough ascertainment of cases. This type of study was conducted in Los Angeles County, California, where 28 twins with a neural tube defect (NTD) were identified. The prevalence in twins (1.6/1,000) was significantly higher than in singletons (1.1/1,000). The study then was expanded to include population-based data from the Medical Birth Registry of Norway which has a comparable overall NTD prevalence (1.0/1,000) and twinning rate (2%). The combined material shows a higher prevalence of anencephaly and encephalocele but not of spina bifida in twins compared to singletons. The male/female ratios in total twin and singleton cases were comparable (0.8), but varied by specific defect. Like-sex twin females appeared at highest risk for NTD as well as for fetal death.

This study supports theories which associate NTDs with monozygotic twins, either through developmental disruptions that cause susceptibility to environmental agents or through a common etiology. Furthermore, it suggests that twins and singletons differ in their response to etiologic factors for the development of NTDs and that the development of each type of NTD may be related to different factors.

Keywords

Neural tube defectsTwinningAnencephalySpina bifidaEncephaloceleCase ascertainmentMalformations in twins
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 31 , Issue 3-4: Special Issue on Twin Pregnancies , July 1982 , pp. 165 - 172
Copyright
Copyright © The International Society for Twin Studies 1982

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