Birth weight in opposite sex twins as compared to same sex dizygotic twins

Effect of Co-twin Fetal Sex on Fetal Anthropometry and Birth Time in Twin Pregnancies

OBJECTIVE

This study of twin deliveries aimed to examine the effect of fetal sex and fetal sex of the co-twin on fetal anthropometry and length of gestation.

METHODS

Pregnancies were grouped as male/male, male/female, and female/female. Birth weight, head circumference, body length and delivery time of newborns were compared between unlike-sex and like-sex twin pregnancies.

RESULTS

A total of 1028 pregnant women who met the inclusion criteria were enrolled in the study. Of these pregnancies, 32.6% (n = 335) were male/male, 33.4% (n = 343) were male/female, and 34.0% (n = 350) were female/female. The discordant (male/female) newborns had a higher total birth weight than concordant twins (P = 0.015). Compared with male newborns from male/female twin pregnancies, male newborns from male/male pregnancies were found to be 129 grams heavier, 0.7 cm longer, and had a 0.4 cm larger head circumference (P<0.001, P=0.023, and P = 0.039, respectively). Pregnancies with male/female fetuses had statistically significantly longer gestations than pregnancies with male/male and female/female fetuses (P = 0.003 and P = 0.004, respectively). The shortest mean gestation was observed in the male/male group. Male/male pregnancies had a 1.53 times higher risk of preterm delivery than male/female pregnancies and a 1.51 times higher risk than female/female pregnancies (OR 1.53; 95% CI 1.07-2.19 and OR 1.51; 95% CI 1.06-2.16, respectively).

CONCLUSIONS

This study suggests that, in twin pregnancies, birthweight, head circumference, and body length are affected by the sex of the co-twin. Male sex is associated with shorter gestation and male/male twin pregnancies are at higher risk for preterm labour.

Birth size and gestational age in opposite-sex twins as compared to same-sex twins: An individual-based pooled analysis of 21 cohorts

It is well established that boys are born heavier and longer than girls, but it remains unclear whether birth size in twins is affected by the sex of their co-twin. We conducted an individual-based pooled analysis of 21 twin cohorts in 15 countries derived from the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins), including 67,850 dizygotic twin individuals. Linear regression analyses showed that boys having a co-twin sister were, on average, 31 g (95% CI 18 to 45) heavier and 0.16 cm (95% CI 0.045 to 0.274) longer than those with a co-twin brother. In girls, birth size was not associated (5 g birth weight; 95% CI −8 to −18 and −0.089 cm birth length; 95% CI −0.202 to 0.025) with the sex of the co-twin. Gestational age was slightly shorter in boy-boy pairs than in boy-girl and girl-girl pairs. When birth size was standardized by gestational age, the magnitude of the associations was attenuated in boys, particularly for birth weight. In conclusion, boys with a co-twin sister are heavier and longer at birth than those with a co-twin brother. However, these differences are modest and partly explained by a longer gestation in the presence of a co-twin sister.

The Impact of Gender on Anthropometric Measures of Twins

INTRODUCTION

Literature suggests that male hormones influence fetal growth in singleton pregnancies. We hypothesized that the same phenomenon is seen in twin gestations.

OBJECTIVES

(1) to identify the impact of gender associated with fetal birth weight, head circumference, and birth length for twins; (2) to examine the effect of gender on standardized fetal growth at birth, according to gestational age and birth order; (3) to examine the effect of gender on placenta weight and dimensions.

METHODOLOGY

This was a population-based retrospective cohort study of twins (4,368 twins, 2,184 pairs) born in British Columbia, Canada from 2000-2010. We excluded twins with stillbirth, congenital anomalies, and those delivered with cesarean section. We also controlled for confounding factors, including birth order, gestational age, maternal anthropometric measures, maternal smoking habits, and obstetric history. A subsample of this population was analyzed from Children and Women Hospital to obtain chorionicity information.

RESULTS

Male-male twins were heavier than male-females and female-female twin pairs (p=.01). Within sex-discordant twin pairs, males were also heavier than females (p=.01). Regression analysis suggested that gender affects birth weight independent of birth order and gestational age. Other newborn anthropometric measures were not found to be dependent on gender. In analyzing a subsample with chorionicity data, birth weight was the only anthropometric measure that was both statistically and clinically affected by sex, even after adjustment for gestational age, chorionicity, birth order, and maternal age.

CONCLUSION

Birth weight was affected by gender while head circumference and birth length were not.

The Natural Course of Monochorionic and Dichorionic Twin Pregnancies: A Historical Cohort

Current early diagnosis, surveillance and intervention options make it hard to determine the natural course of twin pregnancies, especially regarding spontaneous preterm delivery and perinatal mortality. We studied the natural course in monochorionic (MC) and dichorionic (DC) twin pregnancies in a historical cohort. Twin pregnancies were studied in a unique database of 651 twin pairs born in the period 1907 to 1938. We examined the effect of chorionicity on gestational age, birthweight, peri-natal mortality, intertwin birthweight differences, the incidence of preeclampsia and maternal mortality. Perinatal mortality was 27.7% for MC and 15.8% for DC twins (p < .001). Gestational age and birthweight were stronger predictors of perinatal mortality than chorionicity. Perinatal outcome was poorer for the second twin, especially in DC twins. Delivery before 37 weeks of gestation occurred more often in MC twin pregnancies (48.8% compared to 33.3% in DC twin pregnancies). DC twins were on average 288 g (95% confidence interval 201–376) heavier than MC twins. Severe birthweight discordancy occurred equally in MC and DC twins (18.1%). However, if present, mortality was only increased in MC twins. The birthweight of girls was not affected by the presence of a male co-twin. In this historical cohort MC twin pregnancies had a higher perinatal mortality, caused by a high incidence of low birthweight mainly due to preterm delivery. Mortality did not differ in deliveries after 31 weeks of gestation, which is in contrast to recent data. Apparently, modern obstetrics is more effective in reducing mortality in DC twins.

Influence of having a male twin on body mass index and risk for dyslipidemia in middle-aged and old women

BACKGROUND

Animal experiments suggest that exposure to elevated levels of androgens during development by means of so-called hormonal programming causes metabolic aberrations at adulthood. An indirect strategy to address the possible importance of such an influence also in humans would be to study female dizygotic twins, presuming that those with a twin brother--due to diffusion of testosterone--have been exposed to higher androgen levels prenatally.

DESIGN

We have compared 8409 women with a male twin with 9166 women with a dizygotic female twin with respect to self-reported indices of anthropometry and metabolic aberrations at age 42 or older.

RESULTS

Body mass index (BMI), body weight and rate of dyslipidemia were moderately, but significantly, higher in women from opposite-sexed (OS) twin pairs; splitting for age revealed this difference to be present in those ≥ 60 years of age only.

CONCLUSION

The results (i) support the notion that comparisons of women with a twin brother with women from same-sexed twin pairs may be used to shed light on possible long-term effects of interindividual variations in early androgen exposure, and (ii) suggest that the effects of early androgen exposure on metabolism previously observed in animal experiments are of relevance also for humans.

Determinants of handedness in twins

It is well established that the distribution of the combinations of handedness (LL, LR, and RR) in twin pairs is roughly binomial regardless of zygosity or sex. This fact has challenged current genetic models of handedness. We show here that: (a) there must be at least one environmental determinant of handedness; and (b) the binomial distribution does not in itself invalidate genetic models of handedness. In singletons, left-handedness is strongly associated with low birth weight. In twins, this association is weaker (apparently as a consequence of a stronger association with birth order--i.e., with being first-born--within the pair). We speculate that the hazards associated with being first-born in twin pairs (e.g., trauma) are more closely associated with left-handedness than are the hazards associated with being second-born (e.g., hypoxia).

Differences in anthropometric measurements between Sudanese newborn twins and singletons

Twin pregnancies are associated with disturbed fetal growth and a higher risk of low birthweight (LBW), which is one of the most important determinants of perinatal morbidity and mortality in Africa. In this study, we compare anthropometric measurements in Sudanese twins and their mothers with singletons.

METHODS

In 1000 Sudanese mothers with singleton births and 30 mothers with twins, maternal (weight, height, mid-arm circumference) and 11 newborn anthropometric measurements were taken within 24 hours of delivery. Maternal education and socio-economic status were additionally recorded.

RESULTS

Mothers of twins had a significantly higher body weight (p = .045) and lean body mass (p = .02) after delivery, and were from higher social classes in general (p = .014). In addition to gestational age, twins displayed a statistically significant reduction in all anthropometric data, compared to singletons, mainly in terms of birth-weight, chest and head circumference, whereas differences in triceps and subscapular skin fold thickness and ponderal index were distinctly lower. The LBW rate in twins was markedly higher than that in singletons (43.3% vs. 8.3%, p < .001). In 20 out of 30 twins (66.7%), Twin A weighed more than Twin B (difference (SD) of 443 (335) g), and in the remaining 10 cases (33.7%), the weight of Twin B was equal to or more than that of twin A (difference (SD) of 211 (240) g, p = .039). In unlike-sex pairs, the mean (SD) difference between Twins A and B in birthweight was 459 (481) g, which was distinctly higher, compared to same-sex pairs (boys, 180 (325) g and girls, 36 (413) g).

CONCLUSIONS

Sudanese twins displayed significantly reduced anthropometric measurements compared to singletons, but to different degrees. Gender had a higher impact on birthweight in twins than in singletons.

Female prairie vole mate-choice is affected by the males' birth litter composition

Experimental testing and retrospective examination of breeding records were used to examine the influence of sex composition and/or size of males' birth litters on female mate-choice. Sexually naïve female prairie voles (Microtus ochrogaster) avoided males derived from all-male litters, but showed no preference for, or aversion to, males from single-male litters or from more typical mixed-sex litters. Examination of the pregnancy status of females after two weeks of pairing with a male allowed us to estimate the probabilites of a pups' intrauterine position relative to siblings for various litter sizes. The typical prairie vole pup derived from a mixed-sex litter comprised of 4.4 pups, and had a 13% chance of being isolated from siblings in utero and a 22% chance of being between siblings in utero. Pups from single-sex litters tended to be larger at weaning than did pups from mixed-sex litters; however, male size did not influence female choice behavior. These results suggest that some aspect of the perinatal experience of prairie vole pups from single sex litters can influence social interactions later in life.

Does having a twin brother make for a bigger brain?

OBJECTIVE

Brain volume of boys is larger than that of girls by approximately 10%. Prenatal exposure to testosterone has been suggested in the masculinization of the brain. For example, in litter-bearing mammals intrauterine position increases prenatal testosterone exposure through adjacent male fetuses, resulting in masculinization of brain morphology.

DESIGN

The influence of intrauterine presence of a male co-twin on masculinization of human brain volume was studied in 9-year old twins.

METHODS

Magnetic resonance imaging brain scans, current testosterone, and estradiol levels were acquired from four groups of dizygotic (DZ) twins: boys from same-sex twin-pairs (SSM), boys from opposite-sex twin-pairs (OSM), girls from opposite-sex twin-pairs (OSF), and girls from same-sex twin-pairs (SSF; n=119 individuals). Data on total brain, cerebellum, gray and white matter volumes were examined.

RESULTS

Irrespective of their own sex, children with a male co-twin as compared to children with a female co-twin had larger total brain (+2.5%) and cerebellum (+5.5%) volumes. SSM, purportedly exposed to the highest prenatal testosterone levels, were found to have the largest volumes, followed by OSM, OSF and SSF children. Birth weight partly explained the effect on brain volumes. Current testosterone and estradiol levels did not account for the volumetric brain differences. However, the effects observed in children did not replicate in adult twins.

CONCLUSIONS

Our study indicates that sharing the uterus with a DZ twin brother increases total brain volume in 9-year olds. The effect may be transient and limited to a critical period in childhood.

Gender mix in twins and fetal growth, length of gestation and adult cancer risk

This study evaluated the effect of gender mix (the gender combinations of twin pairs) on fetal growth and length of gestation, and reviewed the literature on the long-term effects of this altered fetal milieu on cancer risk. In singletons, it is well established that females weigh less than males at all gestations, averaging 125-135 g less at full term. This gender difference is generally believed to be the result of the effect of androgens on fetal growth. The gender difference in fetal growth is greater before the third trimester and less towards term, with males growing not only more, but also earlier than females. Plurality is a known risk factor for reduced fetal growth and birthweight. Compared with singletons, the mean birthweight percentiles of twins fall substantially (by 10% or more) below the singleton 10th percentile by 28 weeks, below the singleton 50th percentile by 30 weeks, and below the singleton 90th percentile by 34 weeks. In unlike-gender twin pairs, it has been reported that the female prolongs gestation for her brother, resulting in a higher birthweight for the male twin than that of like-gender male twins. Other researchers have demonstrated that females in unlike-gender pairs had higher birthweights than females in like-gender pairs. Analyses from our consortium on 2491 twin pregnancies with known chorionicity showed longer gestations and faster rates of fetal growth in both males and females in unlike-gender pairs compared with like-gender male or female pairs, although these differences were not statistically significant. The post-natal effects for females growing in an androgenic-anabolic environment include increased sensation-seeking behaviour and aggression, lowered visual acuity, more masculine attitudes and masculinising effects of the auditory system and craniofacial growth. In contrast, there is no evidence to suggest that there might be a similar feminising effect on males from unlike-gender pairs. This hormonal exposure in utero may influence adult body size and susceptability to breast cancer.

Gender mix: does it modify birthweight--outcome association?

Gender mix, especially the supposed hormone transfer in utero of the male fetus to his female co-twin, is a highly debated controversial subject. It occurs in animals (free-martin syndrome in the cow) but its existence in man has not been convincingly demonstrated. Two aspects of gender mix effects in man, birthweight and cognitive development, were studied in the Belgian East Flanders Prospective Twin Survey, a large population-based registry of multiple maternities, characterised by accurate data on pregnancy, placental structure and zygosity. The birthweight of the female member of the pair is not influenced by the male co-twin but, unexpectedly, the female twin enhances to a slight degree the birthweight of her male co-twin by prolonging the gestation for a few days. Also unexpectedly, in an opposite direction, the cognitive development, as measured by the IQ (WISC-R) of the female twin rises as compared with controls if her birthweight exceeds that of her male co-twin.

Growth discordance and the effect of a male twin on birth weight of its female co-twin: a population-based study

There is an ongoing controversy whether the presence of a male twin affects the birth weight of its female co-twin, and if affected, whether birth weights of females are lower or higher in the presence of a male co-twin. The purpose of this study was to study this controversy in a large population of 12,639 twin pairs born in Israel between 1993-1998. Comparison of 7566 females in same-sex (FF) pairs with 4900 females in unlike-sex (FM) pairs, adjusted for the lighter and heavier twin in the pair, showed significantly higher birth weights of females in FM pairs. The same trend was found when concordant pairs and discordant pairs (birth weight difference > 25%) were compared separately. No significant difference was found when 7912 males in same-sex (MM) pairs were compared with 4900 males in FM pairs, adjusted for the lighter and heavier sib. Our study supports a definite intrauterine effect of the male twin on birth weight of its female co-twin. This consequence may potentially be associated with fetal programming of adult disease.

Strength and anthropometric measures in identical and fraternal twins: no evidence of masculinization of females with male co-twins

Sharing of intrauterine environment in twins of opposite sex has been hypothesized to result in masculinization of the female twin. We tested this hypothesis by comparing strength (maximum hand-grip pressure) and various anthropometric measures in a newly established survey panel comprising 4,314 middle-aged twins identified through a Danish population-based twin registry. Sex- and zygosity-specific mean values of handgrip strength, height, weight, body mass index, and waist circumference were highly comparable between fraternal twins of opposite sex and fraternal twins of same sex. Our results provide no support for the hypothesis of masculinization of female twins from opposite sex twin pairs.

Left-handedness in twins: genes or environment?

Twin family data can cast light on the longstanding problem about the influences of genes and environment on the etiology of left-handedness. Therefore, hand preference was assessed in 1700 adolescent twin pairs and their parents. Left-handedness (LH) appeared not significantly enhanced among twins compared to the general population. In addition the following observations were made: (1) Significant more LH in first born twins than in second born twins. (2) Significant higher left-handedness association in MZmm pairs compared to DZmm pairs and not or may be marginally so in MZff versus DZff pairs. These results, combined with the observations that (a) left-handed fathers increase the probability of LH in sons but not in daughters; (b) LH in mothers increases LH prevalence in both sons and daughters to the same degree; and (c) very low birth weight, corrected for the effect of gestational age, increases LH prevalence in first born twins only, make an environmental explanation more likely. The possibility that exposure to prenatal male hormones - to which low birth weight and high birth stress children are more vulnerable - might be a crucial condition for the etiology of LH, is discussed.

A twin-singleton comparison of problem behaviour in 2-3-year-olds

Twin-singleton differences in problem behaviours in 2-3-year-olds were studied. Maternal ratings of children's problem behaviours were obtained with the CBCL/2-3. The twin sample consisted of 1363 twin pairs (456 MZ, 907 DZ), the sample of singletons consisted of 420 children from the general population. Results indicated that the general level of problem behaviours in twins was broadly comparable to that in singletons. Four of the seven syndromes showed lower scores for twins. These differences, however, were small and mainly caused by lower scores for DZ twins in comparison to MZ twins and singletons. Part of the difference could be attributed to the higher maternal age in the twin groups. Higher means for boys were found for the total problem score, and the Aggressive and Overactive syndromes.

Effect of maternal smoking on birth weight of twins: a study from the Dutch Twin Register

Since twins weigh about 20% less than singletons at birth, maternal smoking may be a more severe risk for them than for singletons. Therefore, the effect of maternal smoking during pregnancy on birth weight was investigated in a group of 5376 twins. All necessary information was collected by a questionnaire filled out by the mother of the twins. Gestational age explains more than 75% of the variance in birth weight. Other effects were tested with gestational age as a covariate. Apart from zygosity (DZ twins weigh more than MZ twins), birth order (first born twins weigh more than second born twins) and sex (boys weigh more than girls), there was a very significant birth weight reducing effect (more than 8%) maternal smoking as well as a significant influence of maternal age (young mothers give birth to smaller children). There were no interactions with maternal smoking.