Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-27T09:19:17.553Z Has data issue: false hasContentIssue false

Perinatal Mortality and Prevalence of Major Congenital Malformations of Twins in Taipei City

Published online by Cambridge University Press:  01 August 2014

C.J. Chen*
Affiliation:
Institute of Public Health, National Taiwan University College of Medicine, Taipei Institute of Biomedical Sciences, Academia Sinica, Taipei
C.J. Wang
Affiliation:
Department of Nursing, National Cheng-Kung University College of Medicine, Tainan, Taiwan
M.W. Yu
Affiliation:
Institute of Public Health, National Taiwan University College of Medicine, Taipei
T.K. Lee
Affiliation:
Institute of Biomedical Sciences, Academia Sinica, Taipei
*
Institute of Public Health, National Taiwan University College of Medicine, 1, Jen-Ai Road Section 1, Taipei 10018, Taiwan

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

In order to examine perinatal mortality and prevalence of major congenital malformations in twins, deliveries in four teaching hospitals in Taipei City were studied. Among a total of 73,264 deliveries from October 1985 to June 1989, there were 844 pairs of twins. The zygosity of the twin pairs was determined by sex, placentation and 12 red blood cell antigens. There were 482 MZ and 252 DZ twin pairs identified, but the zygosity of a further 110 twin pairs was indeterminable due to lack of information on plancentation and/or blood types. A total of 4,573 singletons delivered in one study hospital from July 1986 to June 1987 were also studied as controls. The perinatal mortality rate was 7.5% for MZ twins, 1.4% for DZ twins, and 0.7% for singletons. The concordance rate of perinatal death was significantly higher in MZ (60%) than in DZ (0%) twins. The prevalence of major congenital malformations was 2.7% for MZ twins, 1.0% for DZ twins, and 0.6% for singletons. The concordance rate of major congenital malformations was 18% for MZ twins, but no DZ pair was concordant in any major congenital malformation. The concordance rate of facial clefts was 29% for MZ twins. There were 2 sets of conjoined twins giving a prevalence rate of 2.7 per 100,000 deliveries. These findings showing the prevalence of perinatal mortality and major congenital malformation to be highest in MZ twins, intermediate in DZ twins and lowest in singletons, suggest the importance of intrauterine environments in the determination of perinatal mortality and congenital malformations.

Type
Research Article
Copyright
Copyright © The International Society for Twin Studies 1992

References

REFERENCES

1. Behrman, SJ (1965): Hazards of twin pregnancies. Postgrad Med 38:7277.CrossRefGoogle ScholarPubMed
2. Benirschke, K, Driscoll, SG (1967): The Pathology of the Human Placenta. New York: Springer-Verlag.CrossRefGoogle Scholar
3. Botting, B, MacDonald-Davis, I, Macfarlane, A (1987): Recent trends in the incidence of multiple births and their mortality. Arch Dis Child 62:941950.Google Scholar
4. Bryan, EM (1992): Twins and higher multiple births: a guide to their nature and nurture. London: Edward Arnold.Google Scholar
5. Cameron, AH, Edwards, JH, Derom, R, Thiery, M, Boelaert, (1983): The value of twin surveys in the study of congenital malformations. Europ J Obstet Gynecol Reprod Biol 14:347356.Google Scholar
6. Campbell, DM, MacGillvray, I (1988): Management of labour and delivery. MacGillivray, I, Campbell, DM, Thompson, B (eds) in: Twinning and twins, pp. 143160. Chichester: John Wiley and Sons.Google Scholar
7. Chen, CJ, Yu, MH, Wang, CJ, Tong, SL, Tien, M, Lee, TY, Lue, HC, Huang, FY, Lan, CC, Yang, KH, Wang, HC, Shih, HY, Liu, CY, Chen, JS (1990): Chronological changes in genetic variance heritability of anthropometric characteristics among Chinese twin infants. Acta Genet Med Gemellol 39:479484.Google ScholarPubMed
8. Corney, G, MacGillivray, I, Campbell, DM, Thompson, B, Little, J (1983): Congenital anomalies in twins in Aberdeen and North-East Scotland. Acta Genet Med Gemellol 28:3135.Google Scholar
9. Douglas, B (1958): The role of environmental factors in the etiology of “so-called” congenital malformations I and II. Plast Reconstr Surg 22:94–108, 214229.CrossRefGoogle Scholar
10. Edmonds, LD, Laude, PM (1982): Conjoined twins in the United States 1970-1977. Teratology 25:301830.CrossRefGoogle ScholarPubMed
11. Ellis, RG, Berger, GS, Keith, L, Depp, R (1979): The Northwestern University Multihospital Twin Study. II. Mortality of first versus second twins. Acta Genet Med Gemellol 28:347352.Google Scholar
12. Emanuel, I, Huang, SW, Gutman, LT, Yu, FC, Linn, CC (1972): The incidence of congenital malformation in a Chinese population: the Taipei collaborative study. Teratology 5:159169.Google Scholar
13. Ferguson, WF (1964): Perinatal mortality in multiple gestations. a review of perinatal death from 1609 multiple gestations. Obstet Gynecol 23:861870.Google ScholarPubMed
14. Hay, S, Wehrung, DA (1970): Congenital malformations in twins. Am J Hun Genet 22:662678.Google Scholar
15. International Clearinghouse for Birth Defects Monitoring Systems (1985): International Clearinghouse for Birth Defects Monitoring, ISSN 0743-5703.Google Scholar
16. Imaizumi, Y (1990): Studies on birth defects and twins in Japan. Congenital Anomalies 30:6978.CrossRefGoogle Scholar
17. Little, J, Bryan, EM (1988): Congenital anomalies in twins. In (eds): MacGillivray, I, Campbell, DM, Thompson, B, Twinning and twins. Chichester: John Wiley & Sons, pp. 207240.Google Scholar
18. Metrakos, JD, Metrakos, K, Baxter, H (1958): Clefts of the lip and palate in twins including a discordant monozygotic pair confirmed by skin transplants. Plast Reconstr Surg 22:109122.Google Scholar
19. Mudalier, AL (1930): Double monsters: study of their circulatory system and some other anatomical abnormalities and complications in labour. J Obstet Gynacol Br Emp 37:753776.Google Scholar
20. Myrianthopoulos, NC (1970): An epidemiologic survey of twins in a large prospectively studied population. Am J Hum Genet 22:611629.Google Scholar
21. Myrianthopoulos, NC (1975): Congenital malformations in twins: epidemiologic survey. Birth Defects Orig Art Ser XI; No. 8, pp. 1–29. New York: Nat. Found. March, of Dimes pp. 129.Google Scholar
22. Myrianthopoulos, NC (1978): Congenital malformations: the contribution of twin studies. Birth Defects 14:151165.Google ScholarPubMed
23. Myrianthopoulos, NC, Melnick, M (1977): Malformations in monozygotic twins: a possible example of environmental influences on the developmental genetic clock. In Gene-environmental interaction in common diseas. Tokio: University of Tokyo Press, pp. 206220.Google Scholar
24. Nylander, PPS (1979): The twinning incidence in Nigeria. Acta Genet Med Gemellol 28:261326.Google Scholar
25. Potter, EL (1963): Twin zygosity and placental form in relation to the outcome of pregnancy. Am J Obstet Gynecol 87:566577.Google Scholar
26. Potter, EL, Craig, JM (1976): Pathology of the fetus and the infant. (3rd ed.) Chicago: Yearbook Medical Publishers, pp. 220271.Google Scholar
27. Registrar General for Scotland (1983): Annual Report, no. 129, Edinburgh: HMSO.Google Scholar
28. Rydhstrom, H (1990): The effects of maternal age, parity and sex of the twins on twins perinatal mortality: a population based study. Acta Genet Med Gemellol 39:401408.Google Scholar
29. Schinzel, AAGL, Smith, DW, Miller, JR (1979): Monozygotic twinning and structural defects. J Pediatr 95:921930.Google Scholar
30. Thompson, B, Pritchard, C, Corney, G (1983): Perinatal mortality in twins by zygosity and plancentation. Paper presented at 4th Congress of International Society for Twins Studies, London.Google Scholar
31. Zake, EZN (1984): Case reports of 16 sets of conjoined twins from a Uganda Hospital. Acta Genet Med Gemellol 33:7580.Google Scholar
32. Zimmerman, AA (1967): Embryologie and anatomic considerations of conjoined twins. Birth Defects Orig. Artic. Ser. 3:1, 1827.Google Scholar