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1.
J Clin Immunol ; 44(4): 99, 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38619739

ABSTRACT

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is characterized by its large heterogeneity in terms of clinical presentation and severity. The pathophysiology of SLE involves an aberrant autoimmune response against various tissues, an excess of apoptotic bodies, and an overproduction of type-I interferon. The genetic contribution to the disease is supported by studies of monozygotic twins, familial clustering, and genome-wide association studies (GWAS) that have identified numerous risk loci. In the early 70s, complement deficiencies led to the description of familial forms of SLE caused by a single gene defect. High-throughput sequencing has recently identified an increasing number of monogenic defects associated with lupus, shaping the concept of monogenic lupus and enhancing our insights into immune tolerance mechanisms. Monogenic lupus (moSLE) should be suspected in patients with either early-onset lupus or syndromic lupus, in male, or in familial cases of lupus. This review discusses the genetic basis of monogenic SLE and proposes its classification based on disrupted pathways. These pathways include defects in the clearance of apoptotic cells or immune complexes, interferonopathies, JAK-STATopathies, TLRopathies, and T and B cell dysregulations.


Subject(s)
Autoimmunity , Lupus Erythematosus, Systemic , Humans , Male , Antigen-Antibody Complex , Autoimmunity/genetics , Genome-Wide Association Study , Lupus Erythematosus, Systemic/genetics , Phenotype , Female , Twin Studies as Topic
2.
Biogerontology ; 25(2): 313-327, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38581556

ABSTRACT

Improving human healthspan in our rapidly aging population has never been more imperative. Telomeres, protective "caps" at the ends of linear chromosomes, are essential for maintaining genome stability of eukaryotic genomes. Due to their physical location and the "end-replication problem" first envisioned by Dr. Alexey Olovnikov, telomeres shorten with cell division, the implications of which are remarkably profound. Telomeres are hallmarks and molecular drivers of aging, as well as fundamental integrating components of the cumulative effects of genetic, lifestyle, and environmental factors that erode telomere length over time. Ongoing telomere attrition and the resulting limit to replicative potential imposed by cellular senescence serves a powerful tumor suppressor function, and also underlies aging and a spectrum of age-related degenerative pathologies, including reduced fertility, dementias, cardiovascular disease and cancer. However, very little data exists regarding the extraordinary stressors and exposures associated with long-duration space exploration and eventual habitation of other planets, nor how such missions will influence telomeres, reproduction, health, disease risk, and aging. Here, we briefly review our current understanding, which has advanced significantly in recent years as a result of the NASA Twins Study, the most comprehensive evaluation of human health effects associated with spaceflight ever conducted. Thus, the Twins Study is at the forefront of personalized space medicine approaches for astronauts and sets the stage for subsequent missions. We also extrapolate from current understanding to future missions, highlighting potential biological and biochemical strategies that may enable human survival, and consider the prospect of longevity in the extreme environment of space.


Subject(s)
Aging , Telomere , Humans , Aging/genetics , Cellular Senescence , Longevity/genetics , Planets , Twin Studies as Topic
3.
PLoS One ; 19(3): e0300518, 2024.
Article in English | MEDLINE | ID: mdl-38512817

ABSTRACT

Research into clinical applications of speech-based emotion recognition (SER) technologies has been steadily increasing over the past few years. One such potential application is the automatic recognition of expressed emotion (EE) components within family environments. The identification of EE is highly important as they have been linked with a range of adverse life events. Manual coding of these events requires time-consuming specialist training, amplifying the need for automated approaches. Herein we describe an automated machine learning approach for determining the degree of warmth, a key component of EE, from acoustic and text natural language features. Our dataset of 52 recorded interviews is taken from recordings, collected over 20 years ago, from a nationally representative birth cohort of British twin children, and was manually coded for EE by two researchers (inter-rater reliability 0.84-0.90). We demonstrate that the degree of warmth can be predicted with an F1-score of 64.7% despite working with audio recordings of highly variable quality. Our highly promising results suggest that machine learning may be able to assist in the coding of EE in the near future.


Subject(s)
Expressed Emotion , Speech , Child , Humans , Emotions , Language , Reproducibility of Results , Twin Studies as Topic
4.
Neurosci Biobehav Rev ; 159: 105576, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38331130

ABSTRACT

Learning to read is a dynamic and cumulative process beginning from birth and continuing through the school years. Empirical data showed a decrease of additive genetic (A) and shared environmental (C) components and an increase of non-shared environmental (E) components from preschool to middle school. However, our understanding of the aetiology of continuity and change of reading skills across this developmental period is limited. Following the PRISMA guidelines, we reviewed the results of behavioral genetic research on reading-related neurocognitive skills of 13 longitudinal twin and adoptive sibling studies spanning from preschool/kindergarten to middle/high school. Our findings suggested that continuity was mainly explained by A components throughout the study periods, and, although to a lesser extent and less consistently, by C components during the early years; change was explained by new E components throughout the years, and also by new A components in the early years. As we are interested in models relevant to traits with early onset during development, it is crucial to deepen the investigation of how developmental time can moderate the genetic and environmental variation.


Subject(s)
Reading , Twins , Child, Preschool , Humans , Longitudinal Studies , Phenotype , Twins/genetics , Twin Studies as Topic , Child , Adolescent
5.
Exp Physiol ; 109(4): 474-483, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38367242

ABSTRACT

Cognitive decline and spinal pain (back pain [BP] and neck pain [NP]) represent a major public health challenge, yet the potential relationship between them remains elusive. A retrospective analysis of the Longitudinal Study of Ageing Danish Twins was performed to determine any potential relationships between BP/NP and cognitive function adjusting for age, sex, educational and socioeconomic status. A total of 4731 adults (2788 females/1943 males) aged 78 ± 6 (SD) years were included in the analysis. We observed a 1-month prevalence of 25% with BP, 21% with NP and 11% for combined BP/NP. While there were no differences in cognition scores for males and females reporting combined BP/NP, compared to those without combined BP/NP (34.38 points [95% confidence interval (CI) = 31.88, 36.88] vs. 35.72 points [95% CI = 35.19, 36.26]; P = 0.180; and 35.72 points [95% CI = 35.19, 36.26] vs. 35.85 points [95% CI = 35.39, 36.31]; P = 0.327; for male and females, respectively), an adjusted analysis revealed that males with combined BP/NP presented with lower cognitive scores compared to males without combined BP/NP (81.26 points [95% CI = 73.80, 88.72] vs. 79.48 points [95% CI = 70.31, 88.66]; P = 0.043). The findings of this hypothesis-generating study may highlight a potential sex-specific association between spinal pain and later-life neurodegeneration.


Subject(s)
Aging , Back Pain , Female , Humans , Male , Back Pain/epidemiology , Back Pain/psychology , Cognition , Denmark/epidemiology , Longitudinal Studies , Neck Pain/epidemiology , Retrospective Studies , Aged , Aged, 80 and over , Twin Studies as Topic
6.
Ugeskr Laeger ; 186(4)2024 01 22.
Article in Danish | MEDLINE | ID: mdl-38305325

ABSTRACT

Studies on cancer loci by use of twin data reveal sources of variation in risk. The Nordic twin and cancer registries contain the largest cohort of population representative twins ever studied with more than median 40 years of follow-up. This article considers findings that show influences on familial risk and demonstrates the strengths of the matched case co-twin design for unraveling important risk factors of cancers. Studies using twin data will expectedly continue to provide insights into cancer epidemiology and genetics for the benefit of prevention and treatment.


Subject(s)
Neoplasms , Twin Studies as Topic , Humans , Diseases in Twins , Neoplasms/epidemiology , Neoplasms/genetics , Registries , Risk Factors
7.
Stat Med ; 43(4): 731-755, 2024 02 20.
Article in English | MEDLINE | ID: mdl-38073579

ABSTRACT

Mendelian randomization (MR) is a popular epidemiologic study design that uses genetic variants as instrumental variables (IVs) to estimate causal effects, while accounting for unmeasured confounding. The validity of the MR design hinges on certain IV assumptions, which may sometimes be violated due to dynastic effects, population stratification, or assortative mating. Since these mechanisms act through parental factors it was recently suggested that the bias resulting from violations of the IV assumptions can be reduced by combing the MR design with the sibling comparison design, which implicitly controls for all factors that are constant within families. In this article, we provide a formal discussion of this combined MR-sibling design. We derive conditions under which the MR-sibling design is unbiased, and we relate these to the corresponding conditions for the standard MR and sibling comparison designs. We proceed by considering scenarios where all three designs are biased to some extent, and discuss under which conditions the MR-sibling design can be expected to have less bias than the other two designs. We finally illustrate the theoretical results and conclusions with an application to real data, in a study of low-density lipoprotein and diastolic blood pressure using data from the Swedish Twin Registry.


Subject(s)
Mendelian Randomization Analysis , Siblings , Humans , Bias , Blood Pressure , Causality , Mendelian Randomization Analysis/methods , Twin Studies as Topic
8.
Genome Biol ; 24(1): 277, 2023 Dec 04.
Article in English | MEDLINE | ID: mdl-38049885

ABSTRACT

BACKGROUND: Recent state-of-the-art sequencing technologies enable the investigation of challenging regions in the human genome and expand the scope of variant benchmarking datasets. Herein, we sequence a Chinese Quartet, comprising two monozygotic twin daughters and their biological parents, using four short and long sequencing platforms (Illumina, BGI, PacBio, and Oxford Nanopore Technology). RESULTS: The long reads from the monozygotic twin daughters are phased into paternal and maternal haplotypes using the parent-child genetic map and for each haplotype. We also use long reads to generate haplotype-resolved whole-genome assemblies with completeness and continuity exceeding that of GRCh38. Using this Quartet, we comprehensively catalogue the human variant landscape, generating a dataset of 3,962,453 SNVs, 886,648 indels (< 50 bp), 9726 large deletions (≥ 50 bp), 15,600 large insertions (≥ 50 bp), 40 inversions, 31 complex structural variants, and 68 de novo mutations which are shared between the monozygotic twin daughters. Variants underrepresented in previous benchmarks owing to their complexity-including those located at long repeat regions, complex structural variants, and de novo mutations-are systematically examined in this study. CONCLUSIONS: In summary, this study provides high-quality haplotype-resolved assemblies and a comprehensive set of benchmarking resources for two Chinese monozygotic twin samples which, relative to existing benchmarks, offers expanded genomic coverage and insight into complex variant categories.


Subject(s)
Benchmarking , East Asian People , Twins, Monozygotic , Humans , East Asian People/genetics , Genomics , Haplotypes , High-Throughput Nucleotide Sequencing , Sequence Analysis, DNA , Twins, Monozygotic/genetics , Twin Studies as Topic
9.
Twin Res Hum Genet ; 26(2): 133-142, 2023 04.
Article in English | MEDLINE | ID: mdl-37272376

ABSTRACT

Joseph has written what purports to be a refutation of studies of Twins Reared-Apart (TRAs) with a singular focus on the Minnesota Study of Twins Reared-Apart (MISTRA). I show, in detail, that (a) his criticisms of previous TRA studies depend on sources that were discredited prior to MISTRA, as they all failed the test of replicability, (b) the list of biases he uses to invalidate MISTRA do not support his arguments, (c) the accusations of questionable research practices are unsubstantiated, (d) his claim that MISTRA should be evaluated in the context of psychology's replication crisis is refuted. The TRA studies are constructive replications. Like many other scholars, past and present, he has been misled by the variation introduced by small samples (sampling error) and the distortion created by walking in the garden of forking paths. His endeavor is a concatenation of elision and erroneous statistical/scientific reasoning.


Subject(s)
Twins, Monozygotic , Twins , Humans , Male , Minnesota , Twins/genetics , Twins, Dizygotic , Twin Studies as Topic
10.
BMC Psychiatry ; 23(1): 442, 2023 06 16.
Article in English | MEDLINE | ID: mdl-37328750

ABSTRACT

BACKGROUND: The causes of obsessive-compulsive disorder (OCD) remain unknown. Gene-searching efforts are well underway, but the identification of environmental risk factors is at least as important and should be a priority because some of them may be amenable to prevention or early intervention strategies. Genetically informative studies, particularly those employing the discordant monozygotic (MZ) twin design, are ideally suited to study environmental risk factors. This protocol paper describes the study rationale, aims, and methods of OCDTWIN, an open cohort of MZ twin pairs who are discordant for the diagnosis of OCD. METHODS: OCDTWIN has two broad aims. In Aim 1, we are recruiting MZ twin pairs from across Sweden, conducting thorough clinical assessments, and building a biobank of biological specimens, including blood, saliva, urine, stool, hair, nails, and multimodal brain imaging. A wealth of early life exposures (e.g., perinatal variables, health-related information, psychosocial stressors) are available through linkage with the nationwide registers and the Swedish Twin Registry. Blood spots stored in the Swedish phenylketonuria (PKU) biobank will be available to extract DNA, proteins, and metabolites, providing an invaluable source of biomaterial taken at birth. In Aim 2, we will perform within-pair comparisons of discordant MZ twins, which will allow us to isolate unique environmental risk factors that are in the causal pathway to OCD, while strictly controlling for genetic and early shared environmental influences. To date (May 2023), 43 pairs of twins (21 discordant for OCD) have been recruited. DISCUSSION: OCDTWIN hopes to generate unique insights into environmental risk factors that are in the causal pathway to OCD, some of which have the potential of being actionable targets.


Subject(s)
Obsessive-Compulsive Disorder , Twins, Monozygotic , Female , Humans , Infant, Newborn , Pregnancy , Brain , Diseases in Twins , Obsessive-Compulsive Disorder/etiology , Obsessive-Compulsive Disorder/genetics , Risk Factors , Twins, Monozygotic/genetics , Twins, Monozygotic/psychology , Twin Studies as Topic
11.
Twin Res Hum Genet ; 26(2): 195-198, 2023 04.
Article in English | MEDLINE | ID: mdl-37170787

ABSTRACT

Waardenburg's syndrome involves deafness accompanied by various visual difficulties. The role of twins in identifying this disorder and advancing understanding of its origins and symptoms is described, beginning in 1916 and continuing to the present. This overview is followed by current research on monozygotic (MZ) twins' different dermatoglyphic features, twins with sagittal suture crainosynostosis, blood pressure in female twins, and MZ twins' education and political knowledge. The final section presents media reports describing controversies surrounding twins created by reciprocal in vitro fertilization, reared-apart triplets' limited TV series, abducted twin infants, the Winkelvoss twins' charges by the Securities and Exchange Commission, and going from 'Me' to 'We'.


Subject(s)
Waardenburg Syndrome , Female , Humans , Infant , Blood Pressure , Dermatoglyphics , Fertilization in Vitro , Sutures , Twins, Dizygotic , Twins, Monozygotic/genetics , Twin Studies as Topic
12.
Cereb Cortex ; 33(14): 9054-9066, 2023 07 05.
Article in English | MEDLINE | ID: mdl-37231165

ABSTRACT

Twin samples allow to conduct a quasi-experimental co-twin case-control approach that can control for genetic and environmental confounding in brain-cognition associations, being more informative on causality compared with studies in unrelated individuals. We conducted a review of studies that have utilized discordant co-twin design to investigate the associations of brain imaging markers of Alzheimer's disease and cognition. Inclusion criteria encompassed twin pairs discordant for cognition or Alzheimer's disease imaging markers and reporting of within-twin pair comparison on the association between cognition and brain measures. Our PubMed search (2022 April 23, updated 2023 March 9) resulted in 18 studies matching these criteria. Alzheimer's disease imaging markers have been addressed only by few studies, most with small sample size. Structural magnetic resonance imaging studies have indicated greater hippocampal volume and thicker cortex in co-twins with better cognitive performance compared with their co-twins with poorer cognitive performance. No studies have looked at cortical surface area. Positron emission tomography imaging studies have suggested that lower cortical glucose metabolism rate and higher cortical neuroinflammation, amyloid, and tau accumulations are related to poorer episodic memory in within-twin pair comparisons. Thus far, only cross-sectional within-twin pair associations of cortical amyloid and hippocampal volume with cognition have been replicated.


Subject(s)
Alzheimer Disease , Cognitive Dysfunction , Humans , Alzheimer Disease/metabolism , Amyloid beta-Peptides/metabolism , Biomarkers , Brain/pathology , Cognitive Dysfunction/pathology , Cross-Sectional Studies , Magnetic Resonance Imaging/methods , Neuroimaging , Positron-Emission Tomography/methods , Twin Studies as Topic
13.
Twin Res Hum Genet ; 26(1): 127-132, 2023 02.
Article in English | MEDLINE | ID: mdl-36924387

ABSTRACT

The experience of going through the personal library of our late esteemed twin research colleague, Dr Irving I. Gottesman, is described. I came away with fond memories and unexpected treasures. This essay is followed by brief reviews of timely research on factors affecting callous-unemotional traits, depressive symptoms in prospective Chinese twin mothers, twins with sagittal suture craniosynostosis, and creative expressiveness and educational achievement. Media reports on informative topics of interest to researchers and the general public include male-female twin Holocaust survivors, nontuplets born in Mali, Indian twins who married the same man, twins born from the longest frozen embryos, an infant twin abduction and twins born in different years.


Subject(s)
Twin Studies as Topic , Humans , Conduct Disorder , Craniosynostoses/genetics , Depression/genetics , East Asian People , Educational Status , Holocaust , Mali , Mothers , Prospective Studies , Survivors , Sutures , Twins, Monozygotic/psychology , Creativity , Twin Studies as Topic/history , History, 20th Century
14.
Twin Res Hum Genet ; 25(4-5): 206-210, 2022 10.
Article in English | MEDLINE | ID: mdl-35920305

ABSTRACT

The unique sources of artistic inspiration and talent of twin artists are examined. The professional literature is rich with twin studies of creativity, but lacking when it comes to specific artistic domains - for example, painting and sculpting. The section that follows provides reviews of current research on ethnic and racial factors affecting type of twin delivery, pregnancy outcomes when twins are conceived naturally or with reproductive assistance, the effects of intrauterine growth discordance on the timing of twin delivery, and three-dimensional (3D) assessment of twins' facial resemblance. The final section summarizes information about twins in the media. The stories include twins distinguished for both baseball playing and physical injuries, twins who reached the National College Athletic Association's Elite 8, a twin pair's grave and epitaph, a mother who conceived twins three times in 2 years, twins in the Hockey Hall of Fame, and a set of superfetated twins.


Subject(s)
Baseball , Basketball , Hockey , Pregnancy Complications , Female , Humans , Pregnancy , Race Factors , Twins , Twin Studies as Topic
15.
Twin Res Hum Genet ; 25(3): 165-170, 2022 06.
Article in English | MEDLINE | ID: mdl-35757955

ABSTRACT

The focus of this article is on insights gained from the extraordinary dynamics that took place between a pair of reunited monozygotic female twins from Greece. Topics include visualizing the co-twin prior to meeting, the unique love and attraction between the twins, a mother's response to discovering her child's cotwin and the challenges posed by insufficient kinship categories. The following section of this article surveys four recent twin research reports. They include Bereavement and Lifespan Associations; Novel Mutations in Twins; Parenting Premature Multiples; and Conjoined Twins. The final part of this article presents interesting and informative news about twins from popular sources. The topics covered are the passing of Madeline Albright (Secretary of State and mother of twins); identical twin songwriters; visually impaired twin and sibling skiiers; identical twin brothers who both received heart transplants; and the naming of the Genain quadruplets.


Subject(s)
Twins, Conjoined , Twins, Monozygotic , Bereavement , Child , Cross-Cultural Comparison , Female , Heart Transplantation , Humans , Longevity , Male , Music , Mutation , Parenting , Siblings , Twin Studies as Topic
16.
Eur Psychiatry ; 65(1): e32, 2022 06 13.
Article in English | MEDLINE | ID: mdl-35694845

ABSTRACT

BACKGROUND: Subthreshold/attenuated syndromes are established precursors of full-threshold mood and psychotic disorders. Less is known about the individual symptoms that may precede the development of subthreshold syndromes and associated social/functional outcomes among emerging adults. METHODS: We modeled two dynamic Bayesian networks (DBN) to investigate associations among self-rated phenomenology and personal/lifestyle factors (role impairment, low social support, and alcohol and substance use) across the 19Up and 25Up waves of the Brisbane Longitudinal Twin Study. We examined whether symptoms and personal/lifestyle factors at 19Up were associated with (a) themselves or different items at 25Up, and (b) onset of a depression-like, hypo-manic-like, or psychotic-like subthreshold syndrome (STS) at 25Up. RESULTS: The first DBN identified 11 items that when endorsed at 19Up were more likely to be reendorsed at 25Up (e.g., hypersomnia, impaired concentration, impaired sleep quality) and seven items that when endorsed at 19Up were associated with different items being endorsed at 25Up (e.g., earlier fatigue and later role impairment; earlier anergia and later somatic pain). In the second DBN, no arcs met our a priori threshold for inclusion. In an exploratory model with no threshold, >20 items at 19Up were associated with progression to an STS at 25Up (with lower statistical confidence); the top five arcs were: feeling threatened by others and a later psychotic-like STS; increased activity and a later hypo-manic-like STS; and anergia, impaired sleep quality, and/or hypersomnia and a later depression-like STS. CONCLUSIONS: These probabilistic models identify symptoms and personal/lifestyle factors that might prove useful targets for indicated preventative strategies.


Subject(s)
Mental Disorders , Adult , Bayes Theorem , Humans , Mental Disorders/epidemiology , Risk Factors , Social Support , Substance-Related Disorders/epidemiology , Twin Studies as Topic , Young Adult
17.
Epigenetics ; 17(12): 1753-1773, 2022 12.
Article in English | MEDLINE | ID: mdl-35608069

ABSTRACT

Although epigenome-wide association studies (EWAS) have been successful in identifying DNA methylation (DNAm) patterns associated with disease states, any further characterization of etiologic mechanisms underlying disease remains elusive. This knowledge gap does not originate from a lack of DNAm-trait associations, but rather stems from study design issues that affect the interpretability of EWAS results. Despite known limitations in predicting the function of a particular CpG site, most EWAS maintain the broad assumption that altered DNAm results in a concomitant change of transcription at the most proximal gene. This study integrated DNAm and gene expression (GE) measurements in two cohorts, the Adolescent and Young Adult Twin Study (AYATS) and the Pregnancy, Race, Environment, Genes (PREG) study, to improve the understanding of epigenomic regulatory mechanisms. CpG sites associated with GE in cis were enriched in areas of transcription factor binding and areas of intermediate-to-low CpG density. CpG sites associated with trans GE were also enriched in areas of known regulatory significance, including enhancer regions. These results highlight issues with restricting DNAm-transcript annotations to small genomic intervals and question the validity of assuming a cis DNAm-GE pathway. Based on these findings, the interpretation of EWAS results is limited in studies without multi-omic support and further research should identify genomic regions in which GE-associated DNAm is overrepresented. An in-depth characterization of GE-associated CpG sites could improve predictions of the downstream functional impact of altered DNAm and inform best practices for interpreting DNAm-trait associations generated by EWAS.


Subject(s)
DNA Methylation , Epigenesis, Genetic , Adolescent , Humans , Young Adult , Epigenomics , Gene Expression , Genome-Wide Association Study , Transcription Factors/genetics , Female , Pregnancy , Twin Studies as Topic
18.
Stat Med ; 41(14): 2513-2522, 2022 06 30.
Article in English | MEDLINE | ID: mdl-35253253

ABSTRACT

It is challenging to evaluate the genetic impacts on a biologic feature and separate them from environmental impacts. This is usually achieved through twin studies by assessing the collective genetic impact defined by the differential correlation in monozygotic twins vs dizygotic twins. Since the underlying order in a twin, determined by latent genetic factors, is unknown, the observed twin data are unordered. Conventional methods for correlation are not appropriate. To handle the missing order, we model twin data by a mixture bivariate distribution and estimate under two likelihood functions: the likelihood over the monozygotic and dizygotic twins separately, and the likelihood over the two twin types combined. Both likelihood estimators are consistent. More importantly, the combined likelihood overcomes the drawback of mixture distribution estimation, namely, the slow convergence. It yields correlation coefficient estimator of root-n consistency and allows effective statistical inference on the collective genetic impact. The method is demonstrated by a twin study on immune traits.


Subject(s)
Twins, Dizygotic , Twins, Monozygotic , Humans , Likelihood Functions , Phenotype , Twin Studies as Topic , Twins, Dizygotic/genetics , Twins, Monozygotic/genetics
19.
Twin Res Hum Genet ; 25(1): 56-61, 2022 02.
Article in English | MEDLINE | ID: mdl-35193725

ABSTRACT

Selected highlights from the 2021 Congress of the International Society for Twin Studies are reviewed. The perspectives of a new graduate student member to the society are also included. Timely research covering issues related to maternal bonding with twins, twins with Peters anomaly, selective termination in dichorionic twin pairs and neuropsychological functioning in twins with neurofibromatosis is reviewed. The final part of this article includes interesting and informative media reports related to the world's most premature survivor who is a twin, identical male baseball players, Malaysian twins switched at birth and a pair of the so-called 'biracial' twins.


Subject(s)
Diseases in Twins , Twin Studies as Topic , Humans , Societies, Scientific
20.
Am J Perinatol ; 39(3): 243-251, 2022 02.
Article in English | MEDLINE | ID: mdl-32722824

ABSTRACT

OBJECTIVE: This study was aimed to report the incidence of neonatal morbidity in monochorionic monoamniotic (MCMA) twin pregnancies according to gestational age at birth and type of management adopted (inpatient or outpatient). STUDY DESIGN: Medline and Embase databases were searched. Inclusion criteria were nonanomalous MCMA twins. The primary outcome was a composite score of neonatal morbidity, defined as the occurrence of at least one of the following outcomes: respiratory morbidity, overall neurological morbidity, severe neurological morbidity, and infectious morbidity, necrotizing enterocolitis at different gestational age windows (24-30, 31-32, 33-34, and 35-36 weeks). Secondary outcomes were the individual components of the primary outcome and admission to neonatal intensive care unit (NICU). Subanalysis according to the type of surveillance strategy (inpatient compared with outpatient) was also performed. Random effect meta-analyses were used to analyze the data. RESULTS: A total of 14 studies including 685 MCMA twin pregnancies without fetal anomalies were included. At 24 to 30, 31 to 32, 33 to 34, and 35 to 36 weeks of gestation, the rate of composite morbidity was 75.4, 65.5, 37.6, and 18.5%, respectively, the rate of respiratory morbidity was 74.2, 59.1, 35.5, and 12.2%, respectively, while overall neurological morbidity occurred in 15.3, 10.2, 4.3, and 0% of the cases, respectively. Infectious morbidity complicated 13, 4.2, 3.1, and 0% of newborns while 92.1, 81.6, 58.7, and 0% of cases required admission to NICU. Morbidity in pregnancies delivered between 35 and 36 weeks of gestation was affected by the very small sample size of cases included. When comparing the occurrence of overall morbidity according to the type of management (inpatient or outpatient), there was no difference between the two surveillance strategies (p = 0.114). CONCLUSION: MCMA pregnancies are at high risk of composite neonatal morbidity, mainly respiratory morbidity that gradually decreases with increasing gestational age at delivery with a significant reduction for pregnancies delivered between 33 and 34 weeks. We found no difference in the occurrence of neonatal morbidity between pregnancies managed as inpatient or outpatient. KEY POINTS: · MCMA pregnancies are at high risk of composite neonatal morbidity, mainly respiratory morbidity.. · Neonatal morbidity gradually decreases with increasing GA at delivery, mostly between 33 and 34 weeks.. · There is no difference in the occurrence of neonatal morbidity between in- or outpatient management..


Subject(s)
Infant, Newborn, Diseases/epidemiology , Pregnancy, Twin , Respiration Disorders/epidemiology , Twins, Monozygotic , Female , Gestational Age , Humans , Incidence , Infant, Newborn , Pregnancy , Twin Studies as Topic
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