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Schubert M, Tihon A, Andresen K, Ruchay Z, Farrokh A, Maass N, Elischer P, Longardt AC, Tesch K, Lebenatus A, Krüger M, Alkatout I. Peripartal management of dichorial twin pregnancy in a bicornuate bicollis uterus: a case report and review of the literature. J Med Case Rep 2024; 18:196. [PMID: 38643176 PMCID: PMC11032606 DOI: 10.1186/s13256-024-04506-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/12/2024] [Indexed: 04/22/2024] Open
Abstract
INTRODUCTION The management of a pregnancy in a bicornuate uterus is particularly challenging. A bicornuate uterus is a rare occurrence and a twin pregnancy in a bicornuate uterus even more rare. These pregnancies call for intensive diagnostic investigation and interdisciplinary care. CASE PRESENTATION We report on a 27-year-old European woman patient (gravida I, para 0) with a simultaneous pregnancy in each cavity of a bicornuate bicollis uterus after embryo transfer. The condition was confirmed by hysteroscopy and laparoscopy. Several unsuccessful in vitro fertilization (IVF) attempts had been performed earlier before embryo transfer in each cornus. After a physiological course of pregnancy with differential screening at 12 + 6 weeks and 22 + 0 weeks of gestation, the patient presented with therapy-resistant contractions at 27 + 2 weeks. This culminated in the uncomplicated spontaneous delivery of the leading fetus and delayed spontaneous delivery of the second fetus. DISCUSSION Only 16 cases of twin pregnancy in a bicornuate unicollis uterus have been reported worldwide and only 6 in a bicornuate bicollis uterus. The principal risks in such pregnancies are preterm labor, intrauterine growth restriction, malpresentation and preeclampsia. These typical risk factors of a twin pregnancy are greatly potentiated in the above mentioned setting. CONCLUSION A twin pregnancy in the presence of a uterine malformation is rare and difficult to manage. These rare cases must be collected and reported in order to work out algorithms of monitoring and therapy as well as issue appropriate recommendations for their management.
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Affiliation(s)
- Melanie Schubert
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany.
| | - Anastasia Tihon
- Department of Obstetrics and Gynecology, University Hospital of Würzburg, 97080, Würzburg, Germany
| | - Kristin Andresen
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Zino Ruchay
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - André Farrokh
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Nicolai Maass
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Philipp Elischer
- Department for Pediatrics and Adolescent Medicine I, Neonatology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Ann Carolin Longardt
- Department for Pediatrics and Adolescent Medicine I, Neonatology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Karolin Tesch
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Annett Lebenatus
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, 24105, Kiel, Germany
| | - Magret Krüger
- Center for Operative Gynecology, Park Clinic, 24116, Kiel, Germany
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospital of Schleswig Holstein, Campus Kiel, 24105, Kiel, Germany.
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Song S, Zhu Z, Mao W, Zhu Y, Zhang R, Bu X, Li H, Han Y, Cao Y, Gao Y, Qiu YP, Wei G, Zhang P, Xie J, Wang M, Chen C, Zhu L. Comparison of singleton and twin birth weight reference percentile curves by gestational age and sex in extremely preterm infants: a population-based study. BMJ Paediatr Open 2024; 8:e002502. [PMID: 38627060 PMCID: PMC11029334 DOI: 10.1136/bmjpo-2024-002502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND With the increasing survival rate of smaller newborns and twins, previous growth curves may not accurately assess the growth of extremely preterm infants (EPIs). Our study aimed to establish birth weight percentile curves for singletons and twins in EPIs from China and the USA and compare the differences between them. METHODS In China, EPIs were from 31 provinces, from 2010 to 2021. The collected information was sex, gestational age, birth weight, singletons and twins. We used the generalised additive models for location scale and shape method to construct the birth weight percentile curves by gestational age and sex for EPIs. The National Vital Statistics System database from 2016 to 2021 was also analysed. We compared the differences between the 50th birth weight percentile curves of the two databases. RESULTS We identified 8768 neonates in China (5536 singletons and 3232 twins) and 121 933 neonates in the USA (97 329 singletons and 24 604 twins). We established the 3rd, 10th, 25th, 50th, 75th, 90th and 97th birth weight reference curves for China and the USA. The results showed that males had higher birth weights than females. In China, for the same gestational age and sex, birth weights in singletons and twins were found to be similar, though singleton males born in China had slightly higher birth weights than male twins. In the USA, birth weights were also similar for females and males, with the same gestational age in singletons and twins. CONCLUSION We established birth weight reference percentile curves by gestational age and sex for singletons and twins among EPIs in China and the USA.
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Affiliation(s)
- Shuting Song
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Zhicheng Zhu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Weiying Mao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yan Zhu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Rong Zhang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Xinghe Bu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Heqin Li
- Department of Neonatology, Baoji Maternity and Child Care Hospital, Shanxi, China
| | - Yanqing Han
- Department of Neonatology, Sichuan Provincial Maternal and Child Health Hospital, Sichuan, China
| | - Yuntao Cao
- Department of Neonatology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yuan Gao
- Department of Neonatalogy, Jinhua Woman's and Children's Hospital, zhejiang, China
| | - Yin-Ping Qiu
- Department of Neonatology, General hospital of Ningxia medical University, Yinchuan, China
| | - Guangyou Wei
- Department of Neonatology, The People's Hospital of Bozhou, Anhui, China
| | - Pingping Zhang
- Department of Neonatology, Tianjin First Central Hospital, Tianjin, China
| | - Jijian Xie
- Department of Neonatology, Affiliated Taihe Hospital of Hubei University of Medicine, Hubei, China
| | - Min Wang
- Department of Neonatology, Yichang Central Hospital, Hubei, China
| | - Chao Chen
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Li Zhu
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
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Abtahi H, Khoshnam-Rad N, Gholamzadeh M, Daraie M, Sabouri F. Conceptual framework for establishing twins prevention and continuous health promotion programme: a qualitative study. BMJ Open 2024; 14:e080443. [PMID: 38604635 PMCID: PMC11015185 DOI: 10.1136/bmjopen-2023-080443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Twin registries and cohorts face numerous challenges, including significant resource allocation, twins' recruitment and retention. This study aimed to assess expert feedback on a proposed pragmatic idea for launching a continuous health promotion and prevention programme (HPPP) to establish and maintain twin cohorts. DESIGN A qualitative study incorporating an inductive thematic analysis. SETTING Tehran University of Medical Sciences. PARTICIPANTS Researchers with expertise in twin studies participated in our study. ANALYSIS AND DESIGN Expert opinions were gathered through focus group discussions (FGDs). Thematic analysis was employed to analyse the findings and develop a model for designing a comprehensive, long-term health promotion programme using ATLAS.ti software. Additionally, a standardised framework was developed to represent the conceptual model of the twin HPPP. RESULTS Eight FGDs were conducted, involving 16 experts. Thematic analysis identified eight themes and seven subthemes that encompassed the critical aspects of a continuous monitoring programme for twin health. Based on these identified themes, a conceptual framework was developed for the implementation of an HPPP tailored for twins. CONCLUSION This study presented the initial endeavour to establish a comprehensive and practical solution in the form of a continuous HPPP designed to tackle the obstacles of twins' cohorts.
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Affiliation(s)
- Hamidreza Abtahi
- Pulmonary and Critical Care Medicine Department, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
- Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Tehran, Iran (the Islamic Republic of)
| | - Niloofar Khoshnam-Rad
- Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Tehran, Iran (the Islamic Republic of)
| | - Marsa Gholamzadeh
- Health Information Management and Medical Informatics Department, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Morteza Daraie
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Fatemeh Sabouri
- Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Tehran, Iran (the Islamic Republic of)
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Desbuissons G, Ngango L, Baudeau C, Fournier P. Successful twin pregnancy in a woman undergoing alternate diurnal and nocturnal hemodialysis. Hemodial Int 2024; 28:233-235. [PMID: 38356167 DOI: 10.1111/hdi.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/28/2023] [Accepted: 01/31/2024] [Indexed: 02/16/2024]
Abstract
Although pregnancy has become more frequent in patients undergoing hemodialysis, it remains a relatively rare event and carries a high risk of complications for both the mother and the fetus. In parallel, multiple pregnancies are also associated with a high risk of complications for the mother and the fetus, even in healthy women. The presence of a twin pregnancy in a woman with chronic renal failure undergoing hemodialysis is an even rarer event and is considered a very high-risk situation. We describe the case of a 31-year-old hemodialysis patient who successfully gave birth to twins at 29 weeks after a period of alternate diurnal and nocturnal hemodialysis.
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Affiliation(s)
- Geoffroy Desbuissons
- Hôpital privé de l'Ouest Parisien, Service de Néphrologie, Trappes, France
- Hôpital Foch, Suresnes, France
| | - Liliane Ngango
- Hôpital privé de l'Ouest Parisien, Service de Néphrologie, Trappes, France
| | | | - Philippe Fournier
- Hôpital privé de l'Ouest Parisien, Service de Néphrologie, Trappes, France
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Habek D, Cerovac A. Full trisomy 14 in one of bichorionic biamniotic twins. Z Geburtshilfe Neonatol 2024; 228:196-197. [PMID: 38196047 DOI: 10.1055/a-2215-6984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
We describe the case of the lethal full trisomy (T) 14 in a fetus from bichorionic biamniotic (BCBA) twin pregnancy. This is a case of a 28-year-old primigravida, with an unremarkable personal and family history, who just like her 30-year-old husband, was without consanguinity between spouses. She conceived spontaneously, without a burdened gynecological-obstetric history. By the 12th week of pregnancy, she had hyperemesis gravidarum and one episode of bleeding due to which progesterone supplementation was prescribed. Due to asymptomatic bacteriuria, she took cefuroxime axetil in the 13th week of pregnancy and azithromycin in the 15th week due to cervicitis with ureaplasma urealyticum.
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Affiliation(s)
- Dubravko Habek
- Ostetrics and Gynecology, Merkur Clinical Hospital, Zagreb, Croatia
- Gyn and Obs, Croatian Catholic University, Zagreb, Croatia
| | - Anis Cerovac
- Department for Gynecology and Obstetrics, University of Tuzla Faculty of Medicine, Tuzla, Bosnia and Herzegovina
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Liu S, Wang L, Gao M, Zhang X, Cui H. Mode of delivery and neonatal outcomes in preterm twins less than 32 weeks of gestation or birthweight under 1500 g: a systematic review and meta-analyses. Arch Gynecol Obstet 2024; 309:1219-1226. [PMID: 38066342 DOI: 10.1007/s00404-023-07307-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/12/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND The mode of delivery for twins born before 32 weeks of gestation remains controversial. Our purpose is to conduct a meta-analysis of twin pregnancies less than 32 weeks or twin weight less than 1500 g, so as to find a suitable delivery mode. METHODS We searched PubMed database, Cochrane Library database, and EMBASE database through December 2022. This protocol was registered with PROSPERO (CRD42023386946) prior to initiation. Studies that compared vaginal delivery to cesarean section for newborns less than 32 weeks of gestation or birthweight under 1500 g were included. The primary result was neonatal mortality rate. Secondary result was neonatal morbidity. The quality of literatures included in the research was evaluated in accordance with Newcastle-Ottawa Scale (NOS) literature quality evaluation scale. We use odds ratio (OR) as the effect index for binary variables. Point estimates and 95% confidence intervals (95% CI) were calculated. P < 0. 05 indicated statistically significant difference. RESULTS Our search generated 5310 articles, and a total of 8 articles comprising a total of 14,703 newborns were included in the analysis. The odds ratios of neonatal mortality rate were for twins delivered by vaginal delivery compared to cesarean section were 0.84 (95% CI 0.57-1.24, P = 0.38). The 5-min Apgar score < 7 (95% CI 0.44-1.75, P = 0.72), necrotizing enterocolitis (95% CI 0.81-1.19, P = 0.82), intraventricular hemorrhage (95% CI 0.41-1.86, P = 0.71), periventricular leukomalacia (95% CI 0.16-4.52, P = 0.84), bronchopulmonary dysplasia (95% CI 0.88-1.36, P = 0.42), and respiratory distress syndrome (95% CI 0.23-2.01, P = 0.48) were not statistically significant between the two groups. CONCLUSION We have observed that vaginal delivery does not confer an increased risk of neonatal morbidity and mortality in twins born before 32 weeks of gestation. However, the current results are affected by substantial heterogeneity and confounding factors. We still need high-quality randomized-controlled studies require to address this important question.
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Affiliation(s)
- Sishi Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Leilei Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Man Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Xue Zhang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China
| | - Hong Cui
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, Liaoning, China.
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Koenders EA, Wesseldijk LW, Boomsma DI, Larsen JK, Vink JM. Heritability of adult picky eating in the Netherlands. Appetite 2024; 195:107230. [PMID: 38278443 DOI: 10.1016/j.appet.2024.107230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/21/2023] [Accepted: 01/18/2024] [Indexed: 01/28/2024]
Abstract
Adult picky eating (APE), the rejection of familiar and unfamiliar foods leading to a diet with limited variety, is an understudied phenomenon which can have both physical and psychological negative consequences. The aetiology of individual differences in APE is understudied, although there is reason to believe that it is partly heritable. Therefore, we aimed to estimate the heritability of APE with data from the Netherlands Twin Register (n = 8016) with classical genetic structural equation modelling. In order to use these data, we firstly investigated whether a Food Preference Questionnaire (FPQ) could measure APE with a pre-registered prestudy. Adult participants (n = 414) filled in online questionnaires, including a FPQ and measures related to APE. Spearman's rho correlation quantified the relationship between different elements of the Dutch FPQ and different scores on measures of APE. Results of the prestudy showed that the mean liking score on the FPQ could be used to measure APE (ρ > .50). This measure was then used in the main study to estimate the heritability of APE. Results showed that broad-sense heritability for APE is 49 % (additive genetic effects 14 % (95 % CI [00, 38]) + dominance genetic effects 35 % (95 % CI [11, 52]), while the remaining variance is explained by unique environmental factors. Future studies may focus on uncovering the specific genetic and unique environmental factors that play a role in APE.
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Affiliation(s)
- Emma A Koenders
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Laura W Wesseldijk
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Netherlands; Department of Cognitive Neuropsychology, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Junilla K Larsen
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Jacqueline M Vink
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands.
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Ventura W, Sugajara R, Quintana W, Llancarí P, Novoa RH. A systematic review of early intrauterine intervention at 12 + 0 to 16 + 6 weeks in twin reversed arterial perfusion sequence. Eur J Obstet Gynecol Reprod Biol 2024; 295:92-97. [PMID: 38342009 DOI: 10.1016/j.ejogrb.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 01/08/2024] [Accepted: 02/01/2024] [Indexed: 02/13/2024]
Abstract
There is some evidence that in twin reversed arterial perfusion sequence, intervention at early gestational age could prevent a spontaneous death of the pump twin, achieving a better global survival. OBJECTIVE To review the perinatal outcomes of early intervention in pregnancies complicated by twin reversed arterial perfusion (TRAP) sequence. STUDY DESIGN A comprehensive search from inception to December 2022 was conducted on databases including MEDLINE, EMBASE, Cochrane Library and LILACS. All studies that reported intervention in twin or triplet pregnancy complicated with TRAP sequence at 12 + 0 to 16 + 6 weeks of gestation were eligible. A descriptive and bivariate analysis was performed. RESULTS Out of the 222 full-text articles, 44 studies reporting 108 cases of early intervention in TRAP sequence were included. A successful procedure was achieved in 105 (95.5 %) interventions: 89 (94.7 %) among twin pregnancies and 16(100 %) among triplet pregnancies. An overall livebirth rate was achieved in 75 patients (70.8 %): intrafetal laser group 55 (73.3 %), radiofrequency 10 (76.9 %) and endoscopic laser 3 (75.0 %). The median gestational age at delivery was 38 + 0 (37 + 4 - 39 + 4) weeks. The median treatment-delivery interval was 23 + 2 (IQR, 21 + 0-25 + 6) weeks. The most frequent adverse outcomes reported were preterm labor in 7 (13.7 %) patients. There were no severe adverse maternal outcomes. CONCLUSION Early intervention with intrafetal laser and radiofrequency in TRAP sequence achieves a livebirth rate of the pump twin of about 75 %.
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Affiliation(s)
- Walter Ventura
- Fetal Medicine Unit, Department of Obstetrics and Perinatology, Instituto Nacional Materno Perinatal, Lima, Peru; Medicina Fetal Peru & Fetal Medicine Unit at Clínica Internacional and Clinica Anglo Americana, Lima, Peru.
| | - Ricardo Sugajara
- Fetal Medicine Unit, Department of Obstetrics and Perinatology, Instituto Nacional Materno Perinatal, Lima, Peru
| | - Willy Quintana
- High-Risk Pregnancy Unit, Department of Obstetrics and Perinatology, Instituto Nacional Materno Perinatal, Lima, Peru
| | - Pedro Llancarí
- Emergency Department, Instituto Nacional Materno Perinatal, Lima, Peru
| | - Rommy H Novoa
- High-Risk Pregnancy Unit, Department of Obstetrics and Perinatology, Instituto Nacional Materno Perinatal, Lima, Peru
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Sheikh SAA, Shah AJ, Bremner JD, Vaccarino V, Inan OT, Clifford GD, Rad AB. Impedance cardiogram based exploration of cardiac mechanisms in post-traumatic stress disorder during trauma recall. Psychophysiology 2024; 61:e14488. [PMID: 37986190 PMCID: PMC10939951 DOI: 10.1111/psyp.14488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 11/22/2023]
Abstract
Post-traumatic stress disorder (PTSD) is an independent risk factor for developing heart failure; however, the underlying cardiac mechanisms are still elusive. This study aims to evaluate the real-time effects of experimentally induced PTSD symptom activation on various cardiac contractility and autonomic measures. We recorded synchronized electrocardiogram and impedance cardiogram from 137 male veterans (17 PTSD, 120 non-PTSD; 48 twin pairs, 41 unpaired singles) during a laboratory-based traumatic reminder stressor. To identify the parameters describing the cardiac mechanisms by which trauma reminders can create stress on the heart, we utilized a feature selection mechanism along with a random forest classifier distinguishing PTSD and non-PTSD. We extracted 99 parameters, including 76 biosignal-based and 23 sociodemographic, medical history, and psychiatric diagnosis features. A subject/twin-wise stratified nested cross-validation procedure was used for parameter tuning and model assessment to identify the important parameters. The identified parameters included biomarkers such as pre-ejection period, acceleration index, velocity index, Heather index, and several physiology-agnostic features. These identified parameters during trauma recall suggested a combination of increased sympathetic nervous system (SNS) activity and deteriorated cardiac contractility that may increase the heart failure risk for PTSD. This indicates that the PTSD symptom activation associates with real-time reductions in several cardiac contractility measures despite SNS activation. This finding may be useful in future cardiac prevention efforts.
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Affiliation(s)
- Shafa-at Ali Sheikh
- Department of Biomedical Informatics, Emory University, Atlanta, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
- Veterans Affairs Health Care System, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, USA
| | - J. Douglas Bremner
- Veterans Affairs Health Care System, USA
- Department of Psychiatry, Emory University School of Medicine, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Omer T. Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, USA
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University, Atlanta, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, USA
| | - Ali Bahrami Rad
- Department of Biomedical Informatics, Emory University, Atlanta, USA
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Li R, Li Q, Yang S, Zeng X, Yan A. An efficient and accurate 2D human pose estimation method using VTTransPose network. Sci Rep 2024; 14:7608. [PMID: 38556570 PMCID: PMC10982291 DOI: 10.1038/s41598-024-58175-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/26/2024] [Indexed: 04/02/2024] Open
Abstract
Human pose estimation is a crucial area of study in computer vision. Transformer-based pose estimation algorithms have gained popularity for their excellent performance and relatively compact parameterization. However, these algorithms often face challenges including high computational demands and insensitivity to local details. To address these problems, the Twin attention module was introduced in TransPose to improve model efficiency and reduce resource consumption. Additionally, to address issues related to insufficient joint feature representation and poor network recognition performance, the enhanced TransPose model, named VTTransPose, replaced the basic block in the third subnet with the intra-level feature fusion module V block. The performance of the proposed VTTransPose model was validated on the public datasets COCO val2017 and COCO test-dev2017. The experimental results on COCO val2017 and COCO test-dev2017 indicate that the AP evaluation index scores of the VTTransPose network proposed are 76.5 and 73.6 respectively, marking improvements of 0.4 and 0.2 over the original TransPose network. Additionally, VTTransPose exhibited a reduction of 4.8G FLOPs, 2M parameters, and approximately 40% lower memory usage during training compared to the original TransPose model. All the experimental results demonstrate that the proposed VTTransPose is more accurate, efficient, and lightweight compared to the original TransPose model.
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Affiliation(s)
- Rui Li
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xian, 710000, China
- Xi'an People's Hospital, Xi'an, China
| | - Qi Li
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xian, 710000, China
| | - Shiqiang Yang
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xian, 710000, China.
| | - Xin Zeng
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xian, 710000, China
| | - An Yan
- School of Mechanical and Precision Instrument Engineering, Xi'an University of Technology, Xian, 710000, China
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De Vito M, Cetraro J, Capannolo G, Alameddine S, Patelli C, D'Antonio F, Rizzo G. Cervical length as a screening tool for preterm birth in twin pregnancies: a systematic review and critical evaluation of quality clinical practice guidelines. J Perinat Med 2024; 52:262-269. [PMID: 38105222 DOI: 10.1515/jpm-2023-0262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/23/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES Twin pregnancies are at increased risk of preterm birth (PTB) compared to singletons. Evaluation of cervical length (CL) represents the optimal tool to screen PTB in singleton. Conversely, there is less evidence on the use of CL in twins. Our aim was to evaluate the methodological quality and clinical heterogeneity of clinical practice guidelines (CPGs) on the CL application in twins using AGREE II methodology. METHODS MEDLINE, Scopus, and websites of the main scientific societies were examined. The following aspects were evaluated: diagnostic accuracy of CL, optimal gestational age at assessment and interventions in twin pregnancies with reduced CL. The quality of the published CPGs was carried out using "The Appraisal of Guidelines for REsearch and Evaluation (AGREE II)" tool. The quality of guideline was rated using a scoring system. Each considered item was evaluated by the reviewers on a seven-point scale that ranges from 1 (strongly disagree) to 7 (strongly agree). A cut-off >60 % identifies a CPGs as recommended. RESULTS The AGREE II standardized domain scores for the first overall assessment had a mean of 74 %. The score was more than 60 % in the 66.6 % of CPGs analyzed indicating an agreement between the reviewers on recommending the use of these CPGs. A significant heterogeneity was found; there was no specific recommendation on CL assessment in about half of the published CPGs. There was also significant heterogeneity on the CL cut-off to prompt intervention. CONCLUSIONS Despite the fact that the AGREE II analysis showed that the majority of the included guidelines are of good quality, there was a significant heterogeneity among CPGs as regard as the indication, timing, and cut-off of CL in twins as well as in the indication of interventions.
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Affiliation(s)
- Marika De Vito
- Department of Obstetrics and Gynecology, Fondazione Policlinico Tor Vergata, Università di Roma Tor Vergata, Rome, Italy
| | - Jessica Cetraro
- Department of Obstetrics and Gynecology, Fondazione Policlinico Tor Vergata, Università di Roma Tor Vergata, Rome, Italy
| | - Giulia Capannolo
- Department of Obstetrics and Gynecology, Università di Chieti, Chieti, Italy
| | - Sara Alameddine
- Department of Obstetrics and Gynecology, Università di Chieti, Chieti, Italy
| | - Chiara Patelli
- Department of Obstetrics and Gynecology, Università di Verona, Verona, Italy
| | - Francesco D'Antonio
- Department of Obstetrics and Gynecology, Università di Chieti, Chieti, Italy
| | - Giuseppe Rizzo
- Department of Obstetrics and Gynecology, Fondazione Policlinico Tor Vergata, Università di Roma Tor Vergata, Rome, Italy
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Ertekin O, Ozer Bekmez B, Buyuktiryaki M, Akin MS, Alyamac Dizdar E, Sari FN. Antenatal corticosteroid administration is associated with lower risk of severe ROP in preterm twin infants. Early Hum Dev 2024; 190:105952. [PMID: 38335761 DOI: 10.1016/j.earlhumdev.2024.105952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/03/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Robust evidence revealed the impact of antenatal corticosteroid (ACS) administration on lower mortality and short-term neonatal outcomes in singleton preterm infants. We aimed to investigate the impact of ACS therapy on morbidity and mortality in preterm twin infants. METHODS We conducted this retrospective single-center study from to the records of twin babies of 24-30 weeks of gestation admitted to the neonatal intensive care unit. The study population was grouped based on the exposure to ACS 1-7 days before birth as received or not. Groups were compared regarding in-hospital mortality and neonatal outcomes. RESULTS Data from 160 twin infants were analyzed. Of those, 102 (64 %) were administered ACS. The median (IQR) gestational age and birth weight of the whole cohort were 28 (27-29) weeks and 1060 (900-1240) g, respectively. ACS administration was associated with a significant decline in respiratory distress syndrome (RDS), requirement ≥2 doses of surfactant, severe intraventricular hemorrhage (IVH), early-onset sepsis (EOS), and retinopathy of prematurity (ROP) requiring treatment (p < 0.05). Logistic regression analysis revealed that gestational age (OR 0.29 95 % CI 0.14-0.62; p = 0.001), ACS administration (OR 0.14 95 % CI 0.03-0.85; p = 0.032), and time to achieve full enteral feeding (OR 1.16 95 % CI 1.03-1.31; p = 0.019) were independently associated with the risk of severe ROP. CONCLUSION The reduction in the risk of severe ROP besides RDS, severe IVH, and EOS among preterm twins who received ACS was remarkable in our study similar to the trials conducted in preterm singletons. However, large-scale prospective observational studies are required to reveal the efficacy of ACS in preterm twins.
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Affiliation(s)
- Omer Ertekin
- Division of Neonatology, Department of Pediatrics, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Buse Ozer Bekmez
- Division of Neonatology, Department of Pediatrics, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Mehmet Buyuktiryaki
- Division of Neonatology, Department of Pediatrics, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Senol Akin
- Division of Neonatology, Department of Pediatrics, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Evrim Alyamac Dizdar
- Division of Neonatology, Department of Pediatrics, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Fatma Nur Sari
- Division of Neonatology, Department of Pediatrics, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
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Wu AHB, Wang CC. Serum free light chains among twin siblings: is the kappa/lambda ratio genetically determined? Biomarkers 2024; 29:100-104. [PMID: 38353603 DOI: 10.1080/1354750x.2024.2319308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/10/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Serum kappa, lambda, the K/λ light chain concentrations are used for screening, diagnosis, and monitoring of patients with multiple myeloma and other plasma cell disorders. Biological variation studies conducted on healthy subjects showed that free light chains have a low within and high between-individual variation. We determined if this variation were genetically linked. METHODS We obtained a single serum sample from 16 pairs of identical twins, 8 neonate twins, and 19 presumed directly-related siblings children, measured Κ and λ light chains and computed the Κ/λ ratio. RESULTS As expected, Κ/λ results from each twin neonate were near identical (reflecting maternal/placental transfer). For older children and adult twins, the Κ/λ ratio form a cluster of results that were a subset of the reference range. There was one outlier, a female with a high, different from her twin sister. She likely had a monoclonal gammopathy (no followup was possible). Excluding this pair, results from neonate twins (14.4% ±10.3%) and non-neonate twins (18.0 ± 15.3%) were not significantly different. Results between non-twin siblings were more scattered (53.2%±53.4%) and different from neonate and non-neonate twin adult and children. CONCLUSION We suggest that the Κ/λ free light chains may be genetically linked.
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Affiliation(s)
- Alan H B Wu
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Chia-Ching Wang
- Department of Medicine, Division of Hematology-Oncology, University of California, San Francisco, CA, USA
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14
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Wainstock T, Yoles I, Sergienko R, Sheiner E. Maternal diabetes following gestational diabetes: Does multiple gestation multiply the risk? Int J Gynaecol Obstet 2024; 164:1047-1052. [PMID: 37698085 DOI: 10.1002/ijgo.15090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE To assess whether the risk for future diabetes is higher among women diagnosed with gestational diabetes (GD) during twin versus singleton gestations. METHOD A retrospective cohort study was performed including all women who delivered at a tertiary medical center between the years 1991 and 2021 and had at least one GD diagnosis. The first GD diagnosis per women was defined as the index pregnancy. Women diagnosed with GD during multiple gestations were compared with women diagnosed with GD during singleton gestations. The outcomes included first hemoglobin A1C (Hba1C) level > 6.4 mg/dL post partum, and the highest level measured during the follow-up period of up to 30 years. Multivariable logistic and Cox proportional analysis were used to compare the risk between the two groups while adjusting for confounding variables. RESULTS The current study included 13 770 mothers, with 458 patients (3.3%) diagnosed with GD during twin gestations and 13 312 (96.7%) during singleton gestations. The mean follow-up was 12.25 ± 9.3 years. Mothers of both groups did not differ in age at index pregnancy; however, mothers of twins were more likely to conceive following fertility treatments. Incidence of diabetes and prediabetes (defined as Hba1C > 6.4 and >5.7, respectively) were lower among the twin-gestation group, both during the 6-month postpartum period (for diabetes: 15.5% vs 22.1%; odds ratio [OR], 0.65 [95% confidence interval (CI), 0.46-0.91]) and during the long-term follow-up (for diabetes: 31.8% vs 40.7%; OR, 0.68 [95% CI, 0.52-0.88]). These results remained significant in the multivariable analysis, while accounting for age, ethnicity, and fertility treatments. CONCLUSION GD diagnosis during multiple versus singleton gestations is associated with a lower risk for future diabetes.
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Affiliation(s)
- Tamar Wainstock
- Department of Public Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Israel Yoles
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ruslan Sergienko
- Department of Public Health, Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Fieni S, Di Ilio C, Kiener AJO, Scebba D, D'Amario P, Dall'Asta A, Ghi T. Real-time ultrasound to assist during a vaginal breech delivery. Am J Obstet Gynecol 2024; 230:S1044-S1045. [PMID: 37278993 DOI: 10.1016/j.ajog.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/07/2023] [Accepted: 03/07/2023] [Indexed: 06/07/2023]
Abstract
We report a novel application of intrapartum sonography, herein used to assist the internal podalic version and the vaginal delivery of a transverse-lying second twin. Following the vaginal delivery of the first cephalic twin, the internal podalic version was performed under continuous ultrasound vision, leading to the uncomplicated breech delivery of a healthy neonate.
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Affiliation(s)
- Stefania Fieni
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Chiara Di Ilio
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy; Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Davide Scebba
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Piernicola D'Amario
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Andrea Dall'Asta
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Tullio Ghi
- Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
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Arnbjerg CJ, Adhikari TB, Musoni-Rwililiza E, Kallestrup P. The twin model: decolonising research and knowledge sharing through equitable collaborations. BMJ 2024; 384:q525. [PMID: 38423554 DOI: 10.1136/bmj.q525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Affiliation(s)
| | | | | | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Denmark
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17
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Puga T, Liu Y, Xiao P, Dai R, Dai HD. Genetic and environmental influence on alcohol intent and alcohol sips among U.S. children-Effects across sex, race, and ethnicity. PLoS One 2024; 19:e0298456. [PMID: 38359015 PMCID: PMC10868864 DOI: 10.1371/journal.pone.0298456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/23/2024] [Indexed: 02/17/2024] Open
Abstract
INTRODUCTION Alcohol intent (the susceptibility to initiating alcohol use) and alcohol sips (the initiation of alcohol) in youth are a multifactorial puzzle with many components. This research aims to examine the connection between genetic and environmental factors across sex, race and ethnicity. METHODS Data was obtained from the twin hub of the Adolescent Brain Cognitive Development (ABCD) study at baseline (2016-2018). Variance component models were conducted to dissect the additive genetic (A), common (C) and unique environmental (E) effects on alcohol traits. The proportion of the total alcohol phenotypic variation attributable to additive genetic factors is reported as heritability (h2). RESULTS The sample (n = 1,772) included an approximately equal male-female distribution. The 886 same-sex twin pairs were 60.4% dizygotic (DZ), 39.6% monozygotic (MZ), 65.4% non-Hispanic Whites, 13.9% non-Hispanic Blacks, 10.8% of Hispanics with a mean age of 121.2 months. Overall, genetic predisposition was moderate for alcohol intent (h2 = 28%, p = .006) and low for alcohol initiation (h2 = 4%, p = 0.83). Hispanics (h2 = 53%, p < .0001) and Blacks (h2 = 48%, p < .0001) demonstrated higher alcohol intent due to additive genetic factors than Whites (h2 = 34%, p < .0001). Common environmental factors explained more variation in alcohol sips in females (c2 = 63%, p = .001) than in males (c2 = 55%, p = .003). Unique environmental factors largely attributed to alcohol intent, while common environmental factors explained the substantial variation in alcohol initiation. CONCLUSION Sex and racial/ethnic disparities in genetic and environmental risk factors for susceptibility to alcohol initiation can lead to significant health disparities. Certain populations may be at greater risk for alcohol use due to their genetic and ecological factors at an early age.
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Affiliation(s)
- Troy Puga
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
- College of Osteopathic Medicine, Kansas City University, Kanas City, MO, United States of America
| | - Yadi Liu
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Peng Xiao
- Dept. of Genetics, Cell Biology & Anatomy, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Ran Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
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Sun Z, Li M, Dong C, Mei S. Clinical characteristics of infantile haemangioma in twins: a retrospective study. BMC Pediatr 2024; 24:111. [PMID: 38350912 PMCID: PMC10863135 DOI: 10.1186/s12887-024-04602-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/30/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Infantile hemangioma is one of the most common benign soft tissue tumors in infants. The pathogenesis of infantile hemangioma remains unclear and twin studies regarding its incidence may help clarify disease pathogenesis. Thus, this study aimed to analyze the clinical characteristics of infantile hemangioma in twin patients and discuss its clinical incidence. METHODS We retrospectively analyzed the data of 83 pairs of twins with infantile hemangioma admitted to the Guangdong Provincial Women and Children Hospital and Henan Provincial People's Hospital between May 2016 and May 2022. Thirty-one pairs of twins among whom both developed infantile hemangioma and 52 pairs of twins among whom only one twin was affected were included. Analysis was performed using the Spearman correlation. Additionally, we analyzed the influence of factors such as sex, twin zygosity, preterm birth, birth weight, and assisted reproduction on the clinical characteristics of twins. RESULTS We observed that disease occurrence in both twins correlated with assisted reproduction (χ2 = 13. 102, P < 0.05) and preterm birth (χ2 = 36.523, P < 0.05). Twin zygosity (χ2 = 0.716, P > 0.05) and total birth weight of twins (t=-3.369, P > 0.05) were not correlated with infantile hemangioma. However, among twins, the ones with lesser birth weight were more likely to develop infantile hemangioma. CONCLUSIONS The clinical characteristics of infantile hemangioma in twins were consistent with their epidemiological characteristics. Female sex, preterm birth, less birth weight, and assisted reproduction increased the probability of morbidity in both twins. Analysis of the characteristics of infantile hemangioma in twins may assist further research and clinical treatment.
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Affiliation(s)
- Zhengwei Sun
- Department of Interventional Radiology and Hemangioma, Guangdong Province Woman and Children Hospital, Guangzhou, People's Republic of China
| | - Miaomiao Li
- Department of Hemangioma and Vascular Malformation, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China.
| | - Changxian Dong
- Department of Hemangioma and Vascular Malformation, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China
| | - Shiwei Mei
- Department of Interventional Radiology and Hemangioma, Guangdong Province Woman and Children Hospital, Guangzhou, People's Republic of China
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García-Cosío Carmena MD, López-Menéndez J. Cardiology and cardiac surgery: twins separated at birth? Rev Esp Cardiol (Engl Ed) 2024; 77:111-112. [PMID: 37931785 DOI: 10.1016/j.rec.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/25/2023] [Indexed: 11/08/2023]
Affiliation(s)
- M Dolores García-Cosío Carmena
- Servicio de Cardiología, Hospital 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, España; Centro de Investigación Biomédica en Red Cardiovascular (CIBERCV), Madrid, España.
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20
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Sepe-Forrest L, Bailey AJ, Quinn PD, Carver FW, Hetrick WP, O’Donnell BF. Alcohol consumption's effects on working memory: Examining familial confounding. Psychol Addict Behav 2024; 38:153-159. [PMID: 37326533 PMCID: PMC10721736 DOI: 10.1037/adb0000936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The purpose of our study was to provide a more rigorous test of the causal hypothesis that chronic alcohol use impairs working memory performance. METHOD We measured linear associations between a latent factor representing alcohol consumption and accuracy across four working memory tasks before and after accounting for familial confounding using a cotwin control design. Specifically, this study examined accuracy through a latent working memory score, the National Institutes of Health (NIH) Toolbox List Sorting, NIH Toolbox Picture Sequence, Penn Word Memory, and 2-back tasks. The study included data from 158 dizygotic and 278 monozygotic twins (Mage = 29 ± 3 years). RESULTS In our initial sample-wide analysis, we did not detect any statistically significant associations between alcohol use and working memory accuracy. However, our cotwin control analyses showed that twins with greater levels of alcohol use exhibited worse scores on the latent working memory composite measure (B = -.25, CI [-.43, -.08], p < .01), Picture Sequence (B = -.31, CI [-.55, -.08], p < .01), and List Sorting (B = -.28, CI [-.51, -.06 ], p = .01) tasks than did their cotwins. CONCLUSIONS These results are consistent with a potentially causal relationship between alcohol use and working memory performance that can be detected only after accounting for confounding familial factors. This highlights the importance of understanding the mechanisms that may underlie negative associations between alcohol use and cognitive performance, as well as the potential factors that influence both alcohol behaviors and cognition. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Linnea Sepe-Forrest
- Department of Psychological & Brain Sciences, Indiana University
- Program in Neuroscience, Indiana University
| | - Allen J. Bailey
- Department of Psychological & Brain Sciences, Indiana University
| | - Patrick D. Quinn
- Department of Psychological & Brain Sciences, Indiana University
- Program in Neuroscience, Indiana University
- School of Public Health, Indiana University
| | | | - William P. Hetrick
- Department of Psychological & Brain Sciences, Indiana University
- Program in Neuroscience, Indiana University
| | - Brian F. O’Donnell
- Department of Psychological & Brain Sciences, Indiana University
- Program in Neuroscience, Indiana University
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Schafer MH, Upenieks L. On religious ambiguity: Childhood family religiosity and adult flourishing in a twin sample. Soc Sci Res 2024; 118:102949. [PMID: 38336416 DOI: 10.1016/j.ssresearch.2023.102949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 09/05/2023] [Accepted: 11/05/2023] [Indexed: 02/12/2024]
Abstract
Ambiguity is an important notion in sociology, denoting situations where social actors and groups carry on without shared meaning. The current article applies this concept to the context of religiosity during people's upbringing, recognizing that multiple factors make family-level religion a complex experience. Indeed, though recent research portrays household religiosity in childhood as a sociocultural exposure with long-term implications for well-being, existing studies have yet to incorporate multiple inputs to consider the cohesiveness of that exposure. Using twin data from a national sample, we investigate whether consistency in recalled household religiosity is associated with mid-life flourishing. Multi-level linear regression models reveal that similarity in twin reports matter, above and beyond the actual level of religiosity individuals report and net of dis/similarity across other childhood recollections. We conclude that coherence in religious upbringing-whether religion was understood to be important or not-is a key ingredient for thriving later in life and then reflect more broadly on manifestations of sociocultural ambiguity in families and in larger social units.
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Meireson E, Dehaene I, Roelens K. Reply to Multifetal pregnancy reduction of trichorionic triplets to twins: what is the benefit? Am J Obstet Gynecol MFM 2024; 6:101259. [PMID: 38104939 DOI: 10.1016/j.ajogmf.2023.101259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Eline Meireson
- Department of Human Structure and Repair, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Department of Obstetrics and Gynaecology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Isabelle Dehaene
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium
| | - Kristien Roelens
- Department of Obstetrics and Gynaecology, Ghent University Hospital, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
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Khan S, Kilpatrick R, Benjamin DK, Kolnik SE, Greenberg RG, Clark R, Zimmerman KO, Puia-Dumitrescu M. Morbidity and mortality of twins and triplets compared to singleton infants delivered between 26-34 weeks gestation in the United States. J Perinatol 2024; 44:231-238. [PMID: 37989884 DOI: 10.1038/s41372-023-01822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/29/2023] [Accepted: 11/02/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To describe in-hospital morbidities and mortality among twins and triplets delivered at ≥26 to ≤34 weeks gestational age (GA) while controlling for prematurity and growth restriction. STUDY DESIGN Retrospective analysis of inborn infants discharged from a neonatal intensive care unit (NICU) managed by the Pediatrix Medical Group between 2010 and 2018. RESULT Among 247 437 infants included, 27.4% were multiples. Adjusted for GA and other factors typically known prior to delivery, in-hospital morbidities varied by plurality and generally were more common in singletons. The odds of death prior to discharge were less for twins at 0.74 (95% CI: 0.67-0.83) and triplets at 0.69 (95% CI: 0.51-0.92) compared to singletons. CONCLUSION Singletons experience greater morbidity and mortality compared to twins and triplets born ≥26 weeks to ≤34 weeks GA, except PDA requiring procedural intervention, ROP requiring treatment, and longer length of stay.
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Affiliation(s)
- Sara Khan
- Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
| | - Ryan Kilpatrick
- Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
- Department of Pediatrics, Duke Clinical Research Institute, Durham, NC, USA
| | | | - Sarah E Kolnik
- Department of Pediatrics, Division of Neonatology, University of Washington and Seattle Children's Hospital, Seattle, WA, USA
| | - Rachel G Greenberg
- Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
- Department of Pediatrics, Duke Clinical Research Institute, Durham, NC, USA
| | - Reese Clark
- Center for Research, Education, Quality, and Safety, Pediatrix Medical Group, Inc, Sunrise, FL, USA
| | - Kanecia O Zimmerman
- Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
- Department of Pediatrics, Duke Clinical Research Institute, Durham, NC, USA
| | - Mihai Puia-Dumitrescu
- Department of Pediatrics, Division of Neonatology, University of Washington and Seattle Children's Hospital, Seattle, WA, USA
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Thompson EJ, Krebs G, Zavos HMS, Steves CJ, Eley TC. The relationship between weight-related indicators and depressive symptoms during adolescence and adulthood: results from two twin studies. Psychol Med 2024; 54:527-538. [PMID: 37650294 DOI: 10.1017/s0033291723002155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND The association between weight and depressive symptoms is well established, but the direction of effects remains unclear. Most studies rely on body mass index (BMI) as the sole weight indicator, with few examining the aetiology of the association between weight indicators and depressive symptoms. METHODS We analysed data from the Twins Early Development Study (TEDS) and UK Adult Twin Registry (TwinsUK) (7658 and 2775 twin pairs, respectively). A phenotypic cross-lagged panel model assessed the directionality between BMI and depressive symptoms at ages 12, 16, and 21 years in TEDS. Bivariate correlations tested the phenotypic association between a range of weight indicators and depressive symptoms in TwinsUK. In both samples, structural equation modelling of twin data investigated genetic and environmental influences between weight indicators and depression. Sensitivity analyses included two-wave phenotypic cross-lagged panel models and the exclusion of those with a BMI <18.5. RESULTS Within TEDS, the relationship between BMI and depression was bidirectional between ages 12 and 16 with a stronger influence of earlier BMI on later depression. The associations were unidirectional thereafter with depression at 16 influencing BMI at 21. Small genetic correlations were found between BMI and depression at ages 16 and 21, but not at 12. Within TwinsUK, depression was weakly correlated with weight indicators; therefore, it was not possible to generate precise estimates of genetic or environmental correlations. CONCLUSIONS The directionality of the relationship between BMI and depression appears to be developmentally sensitive. Further research with larger genetically informative samples is needed to estimate the aetiological influence on these associations.
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Affiliation(s)
- Ellen J Thompson
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Twin Research and Genetic Epidemiology, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Georgina Krebs
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, UK
| | - Helena M S Zavos
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, School of Life Course & Population Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Thalia C Eley
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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25
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Wen YJ, Li DZ. Multifetal pregnancy reduction of trichorionic triplets to twins: what is the benefit? Am J Obstet Gynecol MFM 2024; 6:101258. [PMID: 38104941 DOI: 10.1016/j.ajogmf.2023.101258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Yun-Jing Wen
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Jinsui Road 9, Zhujiang New Town, Guangzhou 510623, China
| | - Dong-Zhi Li
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Jinsui Road 9, Zhujiang New Town, Guangzhou 510623, China.
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26
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Prasad S, Beg S, Badran D, Masciullo L, Huddy C, Khalil A. Neurodevelopmental outcome in complicated twin pregnancy: prospective observational study. Ultrasound Obstet Gynecol 2024; 63:189-197. [PMID: 37550962 DOI: 10.1002/uog.27448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/08/2023] [Accepted: 07/21/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVE Twin pregnancy is associated with increased perinatal mortality and morbidity, but long-term neurodevelopmental outcome remains underinvestigated. The primary objective of this study was to investigate the incidence of adverse neurodevelopment after 1 year of age in complicated monochorionic diamniotic (MCDA) twin pregnancies compared with uncomplicated twin pregnancies. METHODS This was a prospective cohort study conducted at St George's University Hospital NHS Foundation Trust, London, UK. Women with a twin pregnancy culminating in at least one surviving child, aged between 12 and 60 months (corrected for prematurity) at the time of assessment, were invited to complete the relevant Ages and Stages Questionnaire® version 3 (ASQ-3) test. The two study groups were: (1) complicated MCDA twin pregnancies, including those with twin-twin transfusion syndrome, twin anemia-polycythemia sequence, selective fetal growth restriction, twin reversed arterial perfusion sequence and/or single intrauterine demise; and (2) uncomplicated MCDA and dichorionic diamniotic twin pregnancies. The primary outcome measure was an abnormal ASQ-3 score, defined as a score of more than 2 SD below the mean in any one of the five domains. Mixed-effects multivariable logistic regression analysis was performed to determine whether a complicated MCDA twin pregnancy was associated independently with an abnormal ASQ-3 score. RESULTS The study included 174 parents who completed the questionnaire for one or both twins; therefore, 327 ASQ-3 questionnaires were available for analysis. Of those, 117 (35.8%) were complicated MCDA twin pregnancies and 210 (64.2%) were controls. The overall rate of an abnormal ASQ-3 score in children born of a complicated MCDA twin pregnancy was nearly double that of those from uncomplicated twin pregnancies (14.5% vs 7.6%; P = 0.056). Children born of a complicated MCDA twin pregnancy had a significantly higher rate of impairment in the gross-motor domain compared with the control group (8.5% vs 2.9%; P = 0.031). Complicated MCDA twin pregnancies that underwent prenatal intervention had a significantly higher rate of abnormal ASQ-3 score compared with those that did not undergo prenatal intervention (28.1% vs 1.7%; P < 0.001). On multilevel logistic regression analysis, complicated MCDA twin pregnancy was an independent predictor of abnormal ASQ-3 score (adjusted odds ratio, 3.28 (95% CI, 3.27-3.29); P < 0.001). CONCLUSIONS This study demonstrates that survivors of complicated MCDA twin pregnancies have a higher rate of adverse neurodevelopmental outcome, independently of prematurity. Long-term neurodevelopmental follow-up in these pregnancies can ensure timely and optimal management of those affected. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- S Prasad
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - S Beg
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - D Badran
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - L Masciullo
- Department of Obstetrics and Gynecology, Cristo Re Hospital, Rome, Italy
| | - C Huddy
- Department of Neonatology, St George's University Hospital, London, UK
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Twins and Multiples Centre for Research and Clinical Excellence, London, UK
- Fetal Medicine Unit, Liverpool Women's Hospital, University of Liverpool, Liverpool, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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de Jesus Cruz J, Bernardeco J, Rijo C, Cohen A, Serrano F. Hepatic arterial buffer response: activation in donor fetuses and the effect of laser ablation of intertwin anastomosis. J Perinat Med 2024; 52:71-75. [PMID: 37850825 DOI: 10.1515/jpm-2023-0191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES Hepatic arterial buffer response (HABR) is an important defence mechanism for maintaining liver blood flow. It is suspected that HABR is active in monochorionic diamniotic twins (MCDA) with twin-to-twin transfusion syndrome (TTTS) where donor compensates a setting of volume depletion and the recipient an overload. The present study investigates whether in TTTS, HABR is active in donor and/or recipient individually and try to determine if the activation of HABR is a direct response to TTTS. METHODS Hepatic artery (HA) peak systolic velocity (PSV) was measured in normal MCDA fetuses and TTTS. Correlation with relevant fetal Dopplers and characteristics were determined. Z-scores for HA-PSV (HAV-Z) were calculated and its association with TTTS in donors and recipients were determined as well as changes in HAV-Z after laser treatment. RESULTS In this study 118 MCDA were included, 61.9 % normal and 38.1 % TTTS. Of the TTTS 22 required laser treatment. A total of 382 scans were performed in normal group and 155 in TTTS. Our data demonstrates that in donors HAV-Z was 2.4 Z-scores higher compared to normal fetuses (β=2.429 95 % CI 1.887, 2.971; p<0.001) and after laser treatment HAV-Z reduced (β=-1.829 95 % CI -2.593, -1.064; p<0.001). There was no significant difference between recipients and normal (β=-0.092 95 % CI -0.633, 0.449; p=0.738). CONCLUSIONS HABR is active in TTTS, promoting an increased hepatic blood flow in donors. The activation is direct response to TTTS as shown by the reduction in HAV-Z after laser. This finding provides important insights into the pathophysiology of TTTS.
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Affiliation(s)
- Jader de Jesus Cruz
- Department of Fetal Medicine, Central Lisbon University Hospitals, Lisbon, Portugal
| | - Joana Bernardeco
- Department of Fetal Medicine, Central Lisbon University Hospitals, Lisbon, Portugal
| | - Claudia Rijo
- Department of Fetal Medicine, Central Lisbon University Hospitals, Lisbon, Portugal
| | - Alvaro Cohen
- Department of Fetal Medicine, Central Lisbon University Hospitals, Lisbon, Portugal
| | - Fatima Serrano
- Department of Obstetrics, Central Lisbon University Hospitals, Lisbon, Portugal
- Comprehensive Health Research Centre, Universidade Nova de Lisboa, Lisbon, Portugal
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Murray S, Thompson J, Townsend RC, Deidda M, Boyd KA, Norman JE, Norrie J, Boardman JP, Luyt K, Khalil A, Bick D, Reed K, Denton J, Fenwick N, Keerie C, Reynolds R, Stock SJ. Randomised placebo-controlled trial of antenatal corticosteroids for planned birth in twins (STOPPIT-3): study protocol. BMJ Open 2024; 14:e078778. [PMID: 38238048 PMCID: PMC10806667 DOI: 10.1136/bmjopen-2023-078778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/24/2023] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION The aim of the STOPPIT-3 study is to determine the clinical and cost effectiveness of antenatal corticosteroids (ACS) prior to planned birth of twins in a multicentre placebo-controlled trial with internal pilot. METHODS AND ANALYSIS This study will comprise a multicentre, double-blinded, randomised, placebo-controlled trial in at least 50 UK obstetric units. The target population is 1552 women with a twin pregnancy and a planned birth between 35 and 38+6 weeks' gestation recruited from antenatal clinics. Women will be randomised to Dexamethasone Phosphate (24 mg) or saline administered via two intramuscular injections 24 hours apart, 24-120 hours prior to scheduled birth. OUTCOMES The primary outcome is need for respiratory support within 72 hours of birth. Secondary and safety outcomes will be included. Cognitive and language development at age 2 years will be assessed in a subset of participants using the Parent report of Children's Abilities-Revised questionnaire. We will also determine the cost effectiveness of the treatment with ACS compared with placebo. ETHICS AND DISSEMINATION STOPPIT-3 has been funded and approved by the National Institute of Healthcare Research. It has been approved by the West Midlands Research Ethics Committee (22/WM/0018). The results will be disseminated via publication in peer-reviewed journals and conference presentation and will also be communicated to the public via links with charity partners and social media. TRIAL SPONSOR The University of Edinburgh and Lothian Health Board ACCORD, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ. TRIAL REGISTRATION NUMBER ISRCTN59959611.
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Affiliation(s)
- Sarah Murray
- Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Jessica Thompson
- Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Rosie C Townsend
- Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Manuela Deidda
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, UK
| | - Kathleen Anne Boyd
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, UK
| | - Jane E Norman
- University of Nottingham Executive Office, University of Nottingham, Nottingham, UK
| | - John Norrie
- Edinburgh Clinical Trials Unit, The University of Edinburgh, Edinburgh, UK
| | - James P Boardman
- Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
| | - Karen Luyt
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Asma Khalil
- Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - Debra Bick
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Keith Reed
- CEO, Parent Infant Foundation, London, UK
| | - Jane Denton
- Co lead Elizabeth Bryan Multiple Births Centre, Imperial College London, London, UK
| | | | - Catriona Keerie
- University of Edinburgh College of Medicine and Veterinary Medicine, Edinburgh, UK
| | - Rebecca Reynolds
- Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
| | - Sarah Jane Stock
- Centre for Medical Informatics, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
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29
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Zellers S, Alexander J, Ellingson JM, Schaefer JD, Corley RP, Iacono W, Hewitt JK, Hopfer CJ, McGue MK, Vrieze S. Limited psychological and social effects of lifetime cannabis use frequency: Evidence from a 30-year community study of 4,078 twins. J Psychopathol Clin Sci 2024; 133:115-128. [PMID: 38147055 PMCID: PMC10751959 DOI: 10.1037/abn0000867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
BACKGROUND Cannabis use is associated with outcomes like income, legal problems, and psychopathology. This finding rests largely on correlational research designs, which rely at best on statistical controls for confounding. Here, we control for unmeasured confounders using a longitudinal study of twins. METHOD In a sample of 4,078 American adult twins first assessed decades ago, we used cotwin control mixed effects models to evaluate the effect of lifetime average frequency of cannabis consumption measured on substance use, psychiatric, and psychosocial outcomes. RESULTS On average, participants had a lifetime cannabis frequency of about one to two times per month, across adolescence and adulthood. As expected, in individual-level analyses, cannabis use was significantly associated with almost all outcomes in the expected directions. However, when comparing each twin to their cotwin, which inherently controls for shared genes and environments, we observed within-pair differences consistent with possible causality in three of the 22 assessed outcomes: cannabis use disorder symptoms (βW-Pooled = .15, SE = .02, p = 1.7 × 10-22), frequency of tobacco use (βW-Pooled = .06, SE = .01, p = 1.2 × 10-5), and illicit drug involvement (βW-Pooled = .06, SE = .02, p = 1.2 × 10-4). Covariate specification curve analyses indicated that within-pair effects on tobacco and illicit drug use, but not cannabis use disorder, attenuated substantially when covarying for lifetime alcohol and tobacco use. CONCLUSIONS The cotwin control results suggest that more frequent cannabis use causes small increases in cannabis use disorder symptoms, approximately 1.3 symptoms when going from a once-a-year use to daily use. For other outcomes, our results are more consistent with familial confounding, at least in this community population of twins. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Stephanie Zellers
- Department of Psychology, University of Minnesota
- Institute for Molecular Medicine Finland, University of Helsinki
| | | | - Jarrod M. Ellingson
- Department of Psychiatry, University of Colorado Anschutz Medical Campus
- Institute for Behavioral Genetics, University of Colorado Boulder
| | | | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado Boulder
| | | | - John K. Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Christian J. Hopfer
- Department of Psychiatry, University of Colorado Anschutz Medical Campus
- Institute for Behavioral Genetics, University of Colorado Boulder
| | | | - Scott Vrieze
- Department of Psychology, University of Minnesota
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30
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Tiwary P, Bhattacharyya K, A P P. Cycle consistent twin energy-based models for image-to-image translation. Med Image Anal 2024; 91:103031. [PMID: 37988920 DOI: 10.1016/j.media.2023.103031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 09/10/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
Domain shift refers to change of distributional characteristics between the training (source) and the testing (target) datasets of a learning task, leading to performance drop. For tasks involving medical images, domain shift may be caused because of several factors such as change in underlying imaging modalities, measuring devices and staining mechanisms. Recent approaches address this issue via generative models based on the principles of adversarial learning albeit they suffer from issues such as difficulty in training and lack of diversity. Motivated by the aforementioned observations, we adapt an alternative class of deep generative models called the Energy-Based Models (EBMs) for the task of unpaired image-to-image translation of medical images. Specifically, we propose a novel method called the Cycle Consistent Twin EBMs (CCT-EBM) which employs a pair of EBMs in the latent space of an Auto-Encoder trained on the source data. While one of the EBMs translates the source to the target domain the other does vice-versa along with a novel consistency loss, ensuring translation symmetry and coupling between the domains. We theoretically analyze the proposed method and show that our design leads to better translation between the domains with reduced langevin mixing steps. We demonstrate the efficacy of our method through detailed quantitative and qualitative experiments on image segmentation tasks on three different datasets vis-a-vis state-of-the-art methods.
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Affiliation(s)
- Piyush Tiwary
- Department of Electrical Communication Engineering, Indian Institute of Science, Bangalore, Karnataka 560012, India.
| | - Kinjawl Bhattacharyya
- Department of Electrical Engineering, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal 721302, India
| | - Prathosh A P
- Department of Electrical Communication Engineering, Indian Institute of Science, Bangalore, Karnataka 560012, India
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31
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Claudepierre É. ["Thanks to all this good care, we progressed quickly"]. Soins Pediatr Pueric 2024; 45:34-35. [PMID: 38365394 DOI: 10.1016/j.spp.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Sohane and Sélenn are twins and will soon be 6 years old. They had a birth journey often described as unusual, because they were born far too early, at 31 weeks of amenorrhea. Through the pen of their father, they share their testimony with us, looking back on this complicated period of which they were able to keep memories thanks to the photographs and stories of their parents.
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Affiliation(s)
- Éric Claudepierre
- SOS Préma, Antenne de Pau 64, Centre hospitalier universitaire François-Mitterrand de Pau, 4 boulevard Hauterive, 64000 Pau, France.
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32
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Windrim C, Ryan G, Rojas D, Montero D, Higgins M, Windrim R. Remote hands-on training with a novel "video-game" simulator for teaching fetoscopic laser techniques for ablation of placental anastomoses in twin-to-twin syndrome. Prenat Diagn 2024; 44:108-110. [PMID: 38112307 DOI: 10.1002/pd.6490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/01/2023] [Accepted: 12/03/2023] [Indexed: 12/21/2023]
Abstract
Key pointsWhat's already known about this topic?
Twin to twin syndrome (TTTS) is a serious complication of monochorionic twin pregnancy
The treatment of choice is fetoscopic laser ablation of placental anastamoses
Simulation plays an important role in teaching this high‐acuity procedure
What does this study add?
We report the development of a high‐fidelity digital simulation system for teaching TTTS fetoscopic lasers
Remote teaching has been demonstrated to work well with this system
This simulator is robust, easy to store and assemble and relatively inexpensive.
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Affiliation(s)
- Catherine Windrim
- Maternal Fetal Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Greg Ryan
- Maternal Fetal Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - David Rojas
- Maternal Fetal Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Daniel Montero
- Maternal Fetal Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Mary Higgins
- UCD Perinatal Research Centre, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Rory Windrim
- Maternal Fetal Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
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Klein A, Créquit S, Gardet M, Rauturier C, Nivose PL. [Disseminated tuberculosis and bichorionic twin pregnancy : Therapeutic management and maternal and neonatal outcomes. A case report]. Gynecol Obstet Fertil Senol 2024; 52:55-56. [PMID: 37619709 DOI: 10.1016/j.gofs.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/12/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023]
Affiliation(s)
- Anna Klein
- Service de gynécologie-obstétrique, médecin, Centre Hospitaliser Inter-communal André-Grégoire, Montreuil, France; Centre Hospitaliser Inter-communal André-Grégoire, 56, boulevard de la Boissière, 93100 Montreuil, France.
| | - Simon Créquit
- Service de gynécologie-obstétrique, médecin, Centre Hospitaliser Inter-communal André-Grégoire, Montreuil, France
| | - Mona Gardet
- Service de maladies infectieuses, médecin, Centre Hospitaliser Inter-communal André-Grégoire, Montreuil, France
| | - Charles Rauturier
- Service de réanimation néonatale, médecin, Centre Hospitaliser Inter-communal André-Grégoire, Montreuil, France
| | - Pierre-Louis Nivose
- Service de maladies infectieuses, médecin, Centre Hospitaliser Inter-communal André-Grégoire, Montreuil, France
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Shen Y, Zhang H, Wu S, Dong J, Li H, Yang Y, Xu J, Zhang Y, Wang Q, Shen H, Zhang Y, Yan D, Jiang L, Xu X, Quan G, Meng X, He Y, Cai J, Kan H, Ma X. Evaluating the Impact of Maternal Exposure to Ozone on Twin Fetal Growth in China. Environ Sci Technol 2023; 57:20470-20479. [PMID: 38039422 DOI: 10.1021/acs.est.3c04999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Unlike singletons, twins require attention not only to the birth weight of the fetuses but also to discordance (i.e., the differences between weights) because twin growth discordance is a significant factor contributing to perinatal mortality and morbidity in twin pregnancies. However, the impact of maternal air pollution exposure on twin growth discordance has rarely been investigated. We examined the association of long-term ozone exposure during preconception and pregnancy with the birth weight of twins and twin growth discordance among 35,795 twins from the National Free Preconception Health Examination Project between January 2010 and December 2019. Linear mixed-effect models and random-effect logistic regression models were used to examine the associations of ozone exposure with the birth weight-related outcomes (i.e., birth weight of twins and within-pair birth weight difference) and risk of twin growth discordance, respectively, after adjustment for demographic characteristics and lifestyle. We found that an interquartile range (IQR) increase (15 μg/m3) in ozone exposure during the entire pregnancy was associated with a reduction (-28.96g, 95% confidence interval [CI]: -46.37, -11.56) in the total birth weight of twins, and ozone had a more pronounced impact on the birth weight of the smaller fetuses (-18.28 g, 95% CI: -27.22, -9.34) compared to the larger fetuses (-9.88 g, 95% CI: -18.84, -0.92) in twin pregnancies. An IQR increase in ozone exposure during the entire pregnancy was associated with a significant increase (8.41 g, 95% CI: 4.13, 12.69) in the within-pair birth weight difference; the odds ratio (OR) of twin growth discordance related to ozone exposure increased by 9% (OR = 1.09, 95% CI: 1.01, 1.18). However, no consistently significant associations were observed for ozone exposure during prepregnancy. Male-male twin pairs and those who were born prematurely appeared to be more susceptible to ozone exposure than their counterparts. Long-term ozone exposure during pregnancy was associated with twin growth discordance, and our findings provide reference data for future studies.
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Affiliation(s)
- Yang Shen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Hongping Zhang
- Wenzhou People's Hospital, Wenzhou Maternal and Child Health Care Hospital, The Third Clinical Institute Affiliated to Wenzhou Medical University, The Third Affiliated Hospital of Shanghai University, Wenzhou, Zhejiang 325000, China
| | - Shenpeng Wu
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing 100081, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jing Dong
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing 100081, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Huimin Li
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing 100081, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Ying Yang
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing 100081, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jihong Xu
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing 100081, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Ya Zhang
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing 100081, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing 100088, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing 100088, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing 100088, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health Commission of the People's Republic of China, Beijing 100088, China
| | - Lifang Jiang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan 450002, China
| | - Xueyi Xu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Guangbin Quan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Yuan He
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing 100081, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Xu Ma
- National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing 100081, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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Hopkins MK, Neumann O, Kuller JA, Dugoff L. First Trimester Ultrasound and Aneuploidy Screening in Twins. Clin Obstet Gynecol 2023; 66:774-780. [PMID: 37438894 DOI: 10.1097/grf.0000000000000797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
All patients with twin pregnancy should have first trimester ultrasound and be offered screening for chromosomal aneuploidy as well as diagnostic testing. Screening for aneuploidy in twins presents unique challenges compared with singletons. Cell-free DNA screening should be considered first-line; however, this option may not be available or may have limitations in certain clinical scenarios, such as vanishing twins. If cell-free DNA screening is not available, maternal serum marker screening in conjunction with nuchal translucency assessment should be offered. Patients with positive aneuploidy screening tests or fetal structural abnormalities should be offered diagnostic testing.
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Affiliation(s)
- Maeve K Hopkins
- Obstetrics & Gynecology Institute, Cleveland Clinic, Cleveland, Ohio
| | - Olivia Neumann
- Obstetrics & Gynecology Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jeffrey A Kuller
- Division of Maternal and Fetal Medicine, Duke University Hospital, Durham, North Carolina
| | - Lorraine Dugoff
- Divisions of Maternal and Fetal Medicine and Reproductive Genetics, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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Berger DS, Lee YM. Timing of Delivery for Twins. Clin Obstet Gynecol 2023; 66:884-890. [PMID: 37910137 DOI: 10.1097/grf.0000000000000813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
The optimal gestational age for delivery of twin gestations balances the risk to the mother with the risks to the fetus and newborn. Primary considerations should include chorionicity and the presence or absence of other obstetrical complications such as fetal growth restriction or hypertensive disorders of pregnancy. More than half of twin gestations will deliver preterm, and a significant portion will be due to spontaneous labor or medical indications, such that the timing of delivery for twins is typically less determined by the provider discretion. Future studies are needed to assist in clarifying the optimal timing for delivery of twin pregnancies.
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Affiliation(s)
- Dana Senderoff Berger
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, NYU Grossman School of Medicine
| | - Young Mi Lee
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, NYU Langone Health, Maternal Fetal Care Center, New York, New York
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Tesli M, Nesvåg R, Haukvik UK, Gustavson K, Tesli N, Friestad C, Skardhamar T, Naess Ø, Czajkowski N, Kendler KS, Reichborn-Kjennerud T, Ystrom E. Common genetic and environmental risk for personality disorders and psychotic-like experiences in young adult twins. Acta Psychiatr Scand 2023; 148:561-569. [PMID: 37497694 DOI: 10.1111/acps.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION Psychotic-like experiences (PLE) have been associated with the subsequent emergence of psychotic disorders as well as several other domains of psychopathology. In this twin study, we estimated the genetic and environmental correlations between PLE and 10 personality disorders (PD). METHODS Diagnoses of 10 PDs according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and PLE from the Composite International Diagnostic Interview (CIDI) were retrieved for 2793 young adult twins from the Norwegian Twin Registry. Risk for having a PD and PLEs was modeled using item response theory. Biometric twin models were fitted to estimate the genetic and environmental correlations between PDs and PLEs. Co-twin control analysis was performed to estimate additional within-family risk for PLEs when having a PD. RESULTS Phenotypic overlap between PDs and PLEs ranged from 14% to 44% in males and from 11% to 39% in females, with the highest overlap for borderline PD in both sexes. In general, we found higher genetic correlations (r = 0.14-0.72) than environmental correlations (r = 0.06-0.28) between PDs and PLEs. The highest genetic correlations between PLE and PDs were found for borderline (r = 0.72), paranoid (r = 0.56), schizotypal (r = 0.56) and antisocial PD (r = 0.49). CONCLUSION We found that the co-occurrence between PDs and PLE is the best explained by shared genetic determinants, with minor contributions from environmental factors. Interestingly, borderline PD was highly genetically correlated with PLE, warranting molecular genetic studies of this association.
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Affiliation(s)
- Martin Tesli
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Centre for Research and Education in Forensic Psychiatry, Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ragnar Nesvåg
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Unn K Haukvik
- Centre for Research and Education in Forensic Psychiatry, Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin Gustavson
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Natalia Tesli
- Centre for Research and Education in Forensic Psychiatry, Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christine Friestad
- Centre for Research and Education in Forensic Psychiatry, Department of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- University College of Norwegian Correctional Service, Lillestrøm, Norway
| | - Torbjørn Skardhamar
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
| | - Øyvind Naess
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Nikolai Czajkowski
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- PharmacoEpidemiology and Drug Safety Research Group, School of Pharmacy, University of Oslo, Oslo, Norway
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Wei J, Shen N, Shi C, Li N, Yin C, Feng Y, Lu H, Yang X, Zhou L. Exploration of Serum lipid levels during twin pregnancy. J Matern Fetal Neonatal Med 2023; 36:2254891. [PMID: 37710986 DOI: 10.1080/14767058.2023.2254891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
Objective: This study aims to characterize changes in serum lipid levels throughout twin pregnancies and explore the relationship between lipid levels and gestational diabetes mellitus (GDM) and hypertensive disorders complicating pregnancy (HDCP).Methods: We retrospectively studied 297 twin pregnancies of women who received regular prenatal care and delivered at the Beijing Obstetrics and Gynecology Hospital over a period of two years. Demographic and medical data of the participants were collected by questionnaires and medical records review. Serum lipid levels were measured in the first trimester (6-13 weeks), second trimester (24-28 weeks), and third trimester (34-37 weeks). A multivariate regression model was constructed to examine the association between lipid levels and pregnancy complications. A decision tree was used to explore the relationship between early serum lipid glucose levels and GDM and HDCP in twin pregnancies.Results: Triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels increased significantly from the first trimester to the third trimester, with the exception of high-density lipoprotein cholesterol (HDL-C), which decreased in the third trimester in twin pregnancies (p < 0.001). The levels of TC in the GDM and HDCP group were significantly elevated compared to those in the normal group in early pregnancies (p < 0.05, p < 0.05). In the second trimester, TG in the HDCP group was substantially higher than that in the normal group (p = 0.01). In the third trimester, LDL-C and HDL-C levels in the GDM group are significantly lower than that in the normal group (p < 0.05, p < 0.05). After adjusting for confounders, body mass index (BMI) is independently associated with GDM (odds ratio [OR] = 1.129, 95% confidence interval [CI]: 1.007-1.266) and HDCP(odds ratio [OR] = 1.170, 95% confidence interval [CI]: 1.031-1.329). The variation amplitude of HDL-C in the third trimester is related to the occurrence of GDM and HDCP(GDM:OR = 0.271, 95%CI: 0.095-0.778; HDCP: OR =0.249, 95% CI: 0.075-0.823). TG and TC levels in DCDA twins were significantly higher than that in MCDA twins in the first trimester(TG: p < 0.05, TC: p < 0.05). In the decision tree model for GDM, fasting blood glucose in the first trimester (FBG), TC, and pre-pregnancy BMI were identified as important nodes, while in the HDCP model, pre-pregnancy BMI, TC, and TG were key nodes.Conclusion: Serum lipid levels in twin pregnancies increase gradually during pregnancy. BMI is independently associated with the occurrence of GDM and HDCP. HDL-C may serve as a protective factor for GDM and HDCP. The predictive effect of early blood lipid on GDM and HDCP in twin pregnancy needs further study.
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Affiliation(s)
- Jianxia Wei
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Nan Shen
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Cuixia Shi
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Na Li
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Chunnan Yin
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yi Feng
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Hongyan Lu
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiaokui Yang
- Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Li Zhou
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Beijing Maternal and Child Health Care Hospital, Beijing, China
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Sassin AM, Sangi‐Haghpeykar H, Aagaard KM. Fetal sex and the development of gestational diabetes mellitus in gravidae with multiple gestation pregnancies. Acta Obstet Gynecol Scand 2023; 102:1703-1710. [PMID: 37786339 PMCID: PMC10619600 DOI: 10.1111/aogs.14625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION There is an increasing incidence of pregnancies with twin gestations. One outcome more likely to occur with multiple gestations is gestational diabetes mellitus. Studies have suggested that in singleton pregnancies, fetal sex may affect insulin resistance. However, the effects of fetal sex in twins and the development of gestational diabetes mellitus are unknown. We hypothesized that rates of gestational diabetes mellitus and degree of insulin resistance might vary in twin gestations based on the fetal sex pairing: male-male, male-female or female-female. We aimed to employ a large population-based database to ascertain any correlations between fetal sex and gestational diabetes mellitus in multifetal gestations. MATERIAL AND METHODS A two-hospital, single academic institution database comprised of over 39 000 participants with pregnancy data from August 2011 to January 2022 was employed. All twin deliveries of live-born neonates >24 weeks' gestational age from gravidae without preexisting diabetes or twin-twin transfusion syndrome were included. Entries were then grouped based on the fetal sex of the pairing. The presence or absence of gestational diabetes and type of gestational diabetes - diet-controlled (gestational diabetes mellitus classification A1) vs medication-controlled (gestational diabetes mellitus classification A2) - were identified. Statistical analysis was performed using a generalized linear mixed method, and a P-value ≤0.05 was considered statistically significant. RESULTS We identified 1924 twin deliveries that met the inclusion criteria in our database (male-male =652; male-female = 638; female-female = 634). We found no association between fetal sex pairing and the development of gestational diabetes mellitus. There was a significant association between the fetal sex pairing and the type of gestational diabetes mellitus developed, with 32.0% of male-male twins, 33.3% of male-female twins and 58.3% of the female-female twin deliveries associated with medication-controlled gestational diabetes classification A2: male-female vs female-female (P = 0.05) and male-male vs female-female (P = 0.046). CONCLUSIONS While gestational diabetes mellitus is of multifactorial origin, we found a significant association between the fetal sex pairing and the treatment needed for gravidae with twins who develop gestational diabetes mellitus. A higher proportion of female-female twins was associated with gestational diabetes classification A2 compared with male-female or male-male deliveries. Further research on the physiology driving this association is warranted.
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Affiliation(s)
- Alexa M. Sassin
- Department of Obstetrics and GynecologyBaylor College of MedicineHoustonTexasUSA
| | | | - Kjersti M. Aagaard
- Department of Obstetrics and Gynecology, Division of Maternal‐Fetal Medicine, and Departments of Molecular and Human GeneticsMolecular and Cell Biology, and Molecular Physiology and Biophysics, Baylor College of MedicineHoustonTexasUSA
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Sondgeroth KE. Twin Gestation With Spontaneous Reduction To Singleton. Clin Obstet Gynecol 2023; 66:792-803. [PMID: 37910065 DOI: 10.1097/grf.0000000000000820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Twin gestations are at increased risk of single intrauterine fetal death. A first-trimester loss is a common complication in twin gestations. The rate of co-twin morbidity and mortality is higher when a single demise occurs in the second and third trimesters. Monochorionicity strongly influences the prognosis for the surviving co-twin. Fetal ultrasound combined with MRI may be able to help predict neurological injury to the surviving co-twin. The rate of co-twin demise decreases with advancing gestation. After single intrauterine fetal demise, monochorionic gestations should be delivered by 34 weeks and dichorionic by 36 to 37 weeks gestation.
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Dobrosavljevic M, Kuja-Halkola R, Li L, Chang Z, Larsson H, Du Rietz E. Attention-deficit/hyperactivity disorder symptoms and subsequent cardiometabolic disorders in adults: investigating underlying mechanisms using a longitudinal twin study. BMC Med 2023; 21:452. [PMID: 37993878 PMCID: PMC10664476 DOI: 10.1186/s12916-023-03174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Emerging research suggests that attention-deficit/hyperactivity disorder (ADHD) increases the risk for cardiovascular (CVDs) and metabolic disorders (i.e., cardiometabolic disorders) in adulthood. Yet, available studies are scarce and have mainly been focused on individuals receiving clinical ADHD diagnoses. We aimed to investigate the prospective associations of ADHD symptoms in young and mid-adulthood with subsequent cardiometabolic disorders and the underlying mechanisms. METHODS We studied 10,394 twins from the Swedish Twin Registry (STR), born between 1958 and 1985 without previous medical history of cardiometabolic disorders. They provided self-assessment of ADHD symptoms (score range 0-36) via a validated, DSM-IV-based scale in a web-based questionnaire/telephone interview within the Study of Twin Adults: Genes and Environment (STAGE), in 2005-2006 (aged 19-47 years), and were followed until the end of 2018 (33-59 years) to identify incident clinical diagnoses/medication prescriptions for cardiometabolic disorders acquired from Swedish national registers. We used Cox regression models to investigate the associations between ADHD symptoms score and cardiometabolic outcomes, with and without adjustment for relevant covariates, and a co-twin control design to study familial confounding. RESULTS A one-unit increase in the level of ADHD symptoms was associated with a 2% increase in the rate of CVDs (hazard ratio [HR] = 1.02, 95% confidence interval 1.01-1.04) and a 3% increase in the rate of metabolic disorders (HR = 1.03, 1.02-1.05), after adjusting for birth year and sex. The associations were no longer significant after adjusting for educational attainment, lifestyle factors, and comorbid psychiatric disorders. The associations remained significant after adjusting for familial factors shared by dizygotic twin pairs but became nonsignificant after adjusting for factors shared by monozygotic twin pairs. However, the strength of the associations attenuated significantly in monozygotic twins compared to dizygotic twins for CVDs only, suggesting genetic confounding. CONCLUSIONS ADHD symptom score is associated with a higher risk for cardiometabolic disorders, which may be explained by lower educational attainment, adverse lifestyle factors, and psychiatric comorbidities. Moreover, the associations appear to be partly confounded by shared genetic factors, especially for CVDs. Further research is needed to investigate the identified associations at the level of individual cardiometabolic disorders and to follow-up participants until a more advanced older age.
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Affiliation(s)
- Maja Dobrosavljevic
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden.
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lin Li
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Aydin Ü, Gyurkovics M, Ginestet C, Capp S, Greven CU, Palmer J, McLoughlin G. Genetic Overlap Between Midfrontal Theta Signals and Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder in a Longitudinal Twin Cohort. Biol Psychiatry 2023; 94:823-832. [PMID: 37187423 PMCID: PMC10769884 DOI: 10.1016/j.biopsych.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/27/2023] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Cognitive control has been strongly linked to midfrontal theta (4-8 Hz) brain activity. Such control processes are known to be impaired in individuals with psychiatric conditions and neurodevelopmental diagnoses, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Temporal variability in theta, in particular, has been associated with ADHD, with shared genetic variance underlying the relationship. Here, we investigated the phenotypic and genetic relationships between theta phase variability, theta-related signals (the N2, error-related negativity, and error positivity), reaction time, and ADHD and ASD longitudinally in a large twin study of young adults to investigate the stability of the genetic relationships between these measures over time. METHODS Genetic multivariate liability threshold models were run on a longitudinal sample of 566 participants (283 twin pairs). Characteristics of ADHD and ASD were measured in childhood and young adulthood, while an electroencephalogram was recorded in young adulthood during an arrow flanker task. RESULTS Cross-trial theta phase variability in adulthood showed large positive phenotypic and genetic relationships with reaction time variability and both childhood and adult ADHD characteristics. Error positivity amplitude was negatively related phenotypically and genetically to ADHD and ASD at both time points. CONCLUSIONS We showed significant genetic associations between variability in theta signaling and ADHD. A novel finding from the current study is that these relationships were stable across time, indicating a core dysregulation of the temporal coordination of control processes in ADHD that persists in individuals with childhood symptoms. Error processing, indexed by the error positivity, was altered in both ADHD and ASD, with a strong genetic contribution.
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Affiliation(s)
- Ümit Aydin
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom; School of Psychology & Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Máté Gyurkovics
- Centre for Cognitive Neuroscience, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
| | - Cedric Ginestet
- Bioinformatics and Health Statistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Simone Capp
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Corina U Greven
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
| | - Jason Palmer
- School of Mathematical and Data Sciences, West Virginia University, Morgantown, West Virginia
| | - Gráinne McLoughlin
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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Lee KW, Mok MUS, Chai HZ, Yang L. Monochorionic twin pregnancy in a patient with type III osteogenesis imperfecta: a multidisciplinary challenge. BMJ Case Rep 2023; 16:e255738. [PMID: 37967934 PMCID: PMC10660905 DOI: 10.1136/bcr-2023-255738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
A woman with severe type III osteogenesis imperfecta spontaneously conceived a monochorionic, diamniotic twin pregnancy. Due to the severity of her condition, her pregnancy required close follow-up involving a multidisciplinary team, including high-risk obstetricians, anaesthetists, pulmonologists and respiratory therapists. Eventually, the twins were delivered via caesarean section at 26 weeks' gestation.We discuss the challenges and considerations in managing her high-risk pregnancy, highlighting the importance of multidisciplinary care in achieving a safe outcome for mother and babies.
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Affiliation(s)
- Kai Wei Lee
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore
- Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore
| | - May Un Sam Mok
- Department of Anaesthesiology, Singapore General Hospital, Singapore
| | - Hui Zhong Chai
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
| | - Liying Yang
- Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore
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Gósy M, Bunta F, Pregitzer M. Speech processing performance of Hungarian-speaking twins and singletons. Clin Linguist Phon 2023; 37:979-995. [PMID: 36052433 DOI: 10.1080/02699206.2022.2111274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 05/30/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
Studying speech processing in twins versus their singleton peers provides opportunities to study both genetic and environmental effects on how children acquire these aspects of their speech and - by extension - their phonological systems. Our study focused on speech processing in typically developing Hungarian-speaking twins and their singleton peers between 5 and 9 years of age. Participants included 384 monolingual Hungarian-speaking children (192 twins, and 192 singletons). Data from four tasks - repetition of synthesised monosyllables, nonsense words, well-formed noisy sentences, and well-formed phonologically complex sentences - were analysed. There was a main effect for birth status, and singletons outperformed their twin peers on the majority of the speech processing tasks. Age and task also had effects on the performance of the participants, and there was a three-way task by age by twin versus singleton status indicating that the speech processing performance of twins versus singletons is interdependent with the type of task and age. Our results also indicate that monolingual Hungarian-speaking twins may be at higher risk for developmental speech delays relative to their singleton peers.
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Affiliation(s)
- Mária Gósy
- Department of Phonetics, Linguistics Institute ELKH and ELTE University, Budapest, Hungary
| | - Ferenc Bunta
- Department of Communication Sciences and Disorders, University of Houston, Houston, Texas, USA
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Tang X, Wu X, Wang Y. Rapid emergency response after acute aortic dissection in a twin pregnancy. Eur Heart J 2023; 44:4391. [PMID: 37723880 DOI: 10.1093/eurheartj/ehad601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Affiliation(s)
- Xuemei Tang
- Department of Intensive Care Unit, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Second Section, 1st Ring Road, Chengdu 610072, Sichuan, China
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu 610072, China
| | - Xiaoxiao Wu
- Department of Intensive Care Unit, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Second Section, 1st Ring Road, Chengdu 610072, Sichuan, China
| | - Yiping Wang
- Department of Intensive Care Unit, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, No. 32, West Second Section, 1st Ring Road, Chengdu 610072, Sichuan, China
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Chatterjee N, Dun Y. From Hazard Rate to Age-at-Onset Distribution: Mind the Gap. Cancer Epidemiol Biomarkers Prev 2023; 32:1477-1478. [PMID: 37698541 DOI: 10.1158/1055-9965.epi-23-0897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023] Open
Abstract
A recent study published in the journal claimed that genetic susceptibility to breast cancer occurs mainly due to rare inherited variants. The claim relies on a set of deductive arguments following observations on patterns of age-at-onset distribution of the disease among twin pairs. In this brief commentary, we point out a major gap in the given argument due to the interchangeable use of hazard rates and age-at-onset distribution, and thus conclude that the published study does not provide any evidence against polygenic risk of breast cancer due to common variants. See related article by Yasui et al., p. 1518.
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Affiliation(s)
- Nilanjan Chatterjee
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
- Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Yuzheng Dun
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Melamed N, Weitzner O, Church P, Banihani R, Barrett J, Yang J, Wong J, Piedboeuf B, Shah PS. Neonatal and Early Childhood Outcomes of Twin and Singleton Infants Born Preterm. J Pediatr 2023; 262:113377. [PMID: 36871787 DOI: 10.1016/j.jpeds.2023.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 02/02/2023] [Accepted: 02/13/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE To compare neonatal and early-childhood outcomes of twins and singletons born preterm and explore the association of chorionicity with outcomes. STUDY DESIGN This was a national retrospective cohort study of singleton and twin infants admitted at 230/7-286/7 weeks to level III neonatal intensive care units in Canada (2010-2020). The primary neonatal outcome was a composite of neonatal death or severe neonatal morbidities. The primary early-childhood outcome was a composite of death or significant neurodevelopmental impairment. RESULTS The study cohort included 3554 twin and 12 815 singleton infants. Twin infants born at 230/7-256/7 weeks had a greater risk of the composite neonatal outcome (adjusted risk ratio 1.04, 95% CI 1.01-1.07). However, these differences were limited to the subgroups of same-sex and monochorionic twin pregnancies. Twin infants of 230/7-256/7 weeks were also at an increased risk of the composite early-childhood outcome (adjusted risk ratio 1.22, 95% CI 1.09-1.37). Twin infants of 260/7-286/7 weeks were not at an increased risk of adverse neonatal outcomes or the composite early-childhood outcome compared with singleton infants. CONCLUSIONS Among infants born at 230/7-256/7 weeks, twins have a greater risk of adverse neonatal outcomes and the composite early-childhood outcome than singleton infants. However, the increased risk of adverse neonatal outcomes is mostly limited to monochorionic twins and may thus be driven by complications related to monochorionic placentation.
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Affiliation(s)
- Nir Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada.
| | - Omer Weitzner
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Paige Church
- Department of Newborn & Developmental Pediatrics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Rudaina Banihani
- Department of Newborn & Developmental Pediatrics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Jon Barrett
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
| | - Junmin Yang
- Maternal-infant Care (MiCare) Research Centre, Mount Sinai Hospital, Toronto, ON, Canada
| | - Jonathan Wong
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Bruno Piedboeuf
- Department of Pediatrics, CHU de Québec - Université Laval, Quebec City, QC, Canada
| | - Prakesh S Shah
- Maternal-infant Care (MiCare) Research Centre, Mount Sinai Hospital, Toronto, ON, Canada; Department of Pediatrics, University of Toronto, Toronto, ON, Canada
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Seegulam VL. Comment on 'Mortality among twin individuals exposed to loss of a co-twin'. Int J Epidemiol 2023; 52:1665-1666. [PMID: 37141454 PMCID: PMC10555751 DOI: 10.1093/ije/dyad055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 04/20/2023] [Indexed: 05/06/2023] Open
Affiliation(s)
- Vijaya L Seegulam
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA. E-mail:
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Ekström AM, Ottersen OP. Digital twin for pandemic monitoring and prevention: Urgent need for agreements for global data sharing. Proc Natl Acad Sci U S A 2023; 120:e2311969120. [PMID: 37748071 PMCID: PMC10556641 DOI: 10.1073/pnas.2311969120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Affiliation(s)
- Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm171 77, Sweden
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50
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Choi ES, Jung YM, Cho KD, Ha S, Sohn J, Hong SJ, Oh MJ, Park CW, Park JS, Jun JK, Lee SM, Cho GJ. Long-term adverse neurodevelopmental outcomes of discordant twins delivered at term: A nationwide population-based study. BJOG 2023; 130:1370-1378. [PMID: 37077036 DOI: 10.1111/1471-0528.17494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 10/14/2022] [Accepted: 03/26/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To evaluate long-term adverse neurodevelopmental outcomes of discordant twins delivered at term. DESIGN Retrospective cohort study. SETTING Nationwide (Republic of Korea). POPULATION All twin children delivered at term between 2007 and 2010. METHODS The study population was divided into two groups according to inter-twin birthweight discordancy: the 'concordant twin group', twin pairs with inter-twin birthweight discordancy less than 20%; and the 'discordant twin group', twin pairs with inter-twin birthweight discordancy of 20% or more. The risk of long-term adverse neurodevelopmental outcomes was compared between the concordant twin group and the discordant twin group. Long-term adverse neurodevelopmental outcomes between smaller and larger twin children within twin pairs were further analysed. The composite adverse neurodevelopmental outcome was defined as the presence of at least one of the following: motor developmental delay, cognitive developmental delay, autism spectrum disorders/attention deficit hyperactivity disorders, tics/stereotypical behaviour or epileptic/febrile seizure. MAIN OUTCOME MEASURES Long-term adverse neurodevelopmental outcome. RESULTS Of 22 468 twin children (11 234 pairs) included, 3412 (15.19%) twin children were discordant. The risk of composite adverse neurodevelopmental outcome was higher in the discordant twin group than in the concordant twin group (adjusted hazard ratio [HR] 1.13, 95% CI 1.03-1.24). The long-term adverse neurodevelopmental outcomes were not significantly different between smaller and larger twin children in discordant twin pairs (adjusted HR 1.01, 95% CI 0.81-1.28). CONCLUSION In twin pairs delivered at term, an inter-twin birthweight discordancy of 20% or greater was associated with long-term adverse neurodevelopmental outcomes; and long-term adverse neurodevelopmental outcomes were not significantly different in smaller or larger twin children in discordant twin pairs.
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Affiliation(s)
- Eun-Saem Choi
- Department of Obstetrics and Gynaecology, Seoul National University Hospital, Seoul, Korea
- Department of Obstetrics and Gynaecology, Korea University Hospital, Seoul, Korea
| | - Young Mi Jung
- Department of Obstetrics and Gynaecology, Seoul National University Hospital, Seoul, Korea
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu-Dong Cho
- Big Data Department, National Health Insurance Service, Gangwon-do, Korea
| | - Sungyeon Ha
- Graduate School of Statistics, Sungkyunkwan University, Seoul, Korea
| | - Jeongwon Sohn
- Department of Obstetrics and Gynaecology, Seoul National University Hospital, Seoul, Korea
| | - Su Jung Hong
- Department of Obstetrics and Gynaecology, Korea University Hospital, Seoul, Korea
| | - Min-Jeong Oh
- Department of Obstetrics and Gynaecology, Korea University Hospital, Seoul, Korea
| | - Chan-Wook Park
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - Joong Shin Park
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Kwan Jun
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Mi Lee
- Department of Obstetrics and Gynaecology, Seoul National University Hospital, Seoul, Korea
- Department of Obstetrics and Gynaecology, Seoul National University College of Medicine, Seoul, Korea
- Innovative Medical Technology Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynaecology, Korea University Hospital, Seoul, Korea
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