Secular changes in twinning and triplet rates were analyzed using vital statistics in Austria, the Czech Republic, the Slovak Republic, England and Wales, Germany, the Netherlands, Switzerland, Denmark, Finland, Norway, Sweden, Canada, Australia, Hong Kong, Israel, Japan, and Singapore during the period from 1972 to 1996. Among those 17 countries, the twinning and triplet rates in the Czech Republic and in the Slovak Republic remained constant from 1972 to 1994, whereas these rates increased significantly year by year in the other 15 countries during the examined period in each country. Twinning rates increased from 1.2-fold in Austria to 2-fold in Denmark from 1972 to 1996. As for triplets, the rate increased from 3-fold in Denmark to 9-fold in Norway during that period. With one exception, that being the Slovak Republic, the triplet rate was highest in the Scandinavian countries, followed by the other European and Asian countries. The rising twinning and triplet rates have been attributed to the higher proportion of mothers treated with ovulation-inducing hormones and partially attributed to IVF.

The genetic and environmental determinants of a brief assessment of metabolic rate at rest and under psychological stress were studied in 40 pairs of monozygotic and 40 pairs of dizygotic young adult male twins. Height, weight and age were employed as covariates. Univariate analyses showed a high heritability for height and weight and moderate heritability for metabolic rate. Classical twin analyses and multivariate genetic modeling indicated that genetic influences on resting metabolic rate were entirely explained by body weight: there was no independent genetic contribution to resting metabolic rate. Metabolic rate under psychological stress, on the other hand, showed a significant genetic effect. The exponent (3/4) in the power function relating body weight to resting metabolic rate was the same as that found in a wide variety of animal species, a value that has been proposed as defining a body weight set point. We speculate that an adult body weight set point is genetically transmitted. Independent genetic effects on resting metabolic rate would be observed only when the normal equilibrium between body weight and metabolic rate is unbalanced during development, aging or disease. The study illustrates the use of multivariate genetic analyses of twin data which may be readily applied to widely used metabolic rate assessments.

Trends of twinning rates were analyzed using vital statistics in Austria, Finland, Norway, Sweden, Canada, Australia, Hong Kong, Israel, Japan, and Singapore during the period from 1972 to 1996. The twinning rates increased significantly year by year in each country. During these periods, the twinning rate increased by twenty percent in Austria and Canada, and by sixty percent in Norway and Sweden. The twinning rate was 1.6 times higher in Sweden than in Hong Kong in 1972 and by eighty percent in Israel in 1995. Twinning rates were higher in European countries, Canada, and Australia than in Asia. The variations of the twinning rates among countries were not only due to biological factors, but also to assisted reproductive techniques. In Australia, the overall twinning rate was 1.3 times higher in the nuptial births (14.1 per 1000 births) than in the ex-nuptial births (10.7) during the period 1994-1996. As for maternal age, twinning rates in Sweden increased year by year for maternal age groups except the youngest and the oldest age groups. In Sweden, the rising twinning rate has been attributed to the higher proportion of mothers (for the 25-39 year old age groups) treated with ovulation-inducing hormones and attributed to in-vitro fertilization.

This study investigated the degree of risk of handicap in twins, triplets, quadruplets and quintuplets and associated factors, and examined the clustering tendency of handicaps. The sample was recruited from the Kinki University Twin and Higher Order Multiple Birth Registry. This panel consisted of 705 pairs of twins (1410 twins), 96 sets of triplets (287 triplets excluding 1 infant death), 7 sets of quadruplets (27 quadruplets excluding 1 infant death), and 2 sets of quintuplets (10 quintuplets), all of whom were born after 1977. The incidence of handicap was 3.7% in twins, 8.7% in triplets, 11.1% in quadruplets, and 10.0% in quintuplets. The risk of prodicing at least 1 handicapped child was approximately 1 in 13 pairs of twins (7.4%), 1 in 4 or 5 sets of triplets (21.6%), and 1 in 2 sets of quadruplet and quintuplets (50%). There was a significantly higher clustering tendency of handicaps in twins and triplets compared with the expected frequency calculated from the incidence rate of handicap. Four significant risk factors for subsequent handicap were found by logistic regression: gestation number, shortening of gestational age, premature rupture of the membrane, and toxemia during pregnancy.

Respiratory sinus arrhythmia (RSA) has been shown to be a sensitive index of vagal cardiac control. We studied the genetic and nongenetic influences on individual differences in RSA in a sample of 160 adolescent twins. RSA was measured during rest and across two different tasks. Results show that heritability is task dependent. The amount of genetic variance is the same, however, during rest and task conditions. Because nonshared environmental variance decreases during tasks, heritability is larger for RSA measured under more stressful conditions than for RSA as measured during rest. Multivariate models assessed the continuity of the genetic and environmental influences and show genetic influences to be the same across different conditions, while environmental influences are different. More specifically, a one-factor model is found for genetic influences and a second-order autoregressive model for the environmental factors.

A study has been made of 35 patients belonging to 20 families, all diagnosed as Usher's syndrome (retinitis pigmentosa and deafness). The results indicate that there are four clinical types, which have been called Types I to IV. Genetically, they represent at least two, and possibly three or four, separate entities.

Triplet pregnancy of over 20 weeks gestation occurred 20 times during 75,506 deliveries at a referral hospital. Commonly occurring maternal complications included premature delivery (75%), antepartum anemia (35%), postpartum hemorrhage (35%), preeclampsia (20%), and premature spontaneous rupture of the membranes (20%). Malpresentation was common. Neonatal complications were also common and included respiratory distress syndrome (45%), presumptive sepsis (36.6%), hyperbilirubinemia (33%), and neonatal death (21.6%). These high complication rates emphasize the importance of early identification and referral center care for these vulnerable pregnancies.

A flexible method based on maximum likelihood theory is introduced for the analysis of binary response data in twins. The method allows for explanatory variables such as age and sex, is free of the untestable distributional assumption of bivariate normality of liability, and makes more efficient use of the data available. The method is illustrated with preliminary data on drinking status in adult twins. Although there is some bias in the ascertainment of male dizygous twins, the results suggest that monozygous twins are more concordant than dizygous twins for drinking status.

The birth of twins is often accompanied by complications which may affect both twins equally (eg, prematurity) or which may establish differences between the twins (eg, one coming home from hospital first). Parents' ratings of behaviour may reflect and even perpetuate the influence of such variables and it is of interest to see if people less familiar with the twins' history can observe any long-term effects. In the La Trobe Twin Study teachers routinely complete the Bristol Social Adjustment Guide, an assessment of social maladjustment in children aged 5-16 years. Extreme prematurity and problems at delivery were generally associated with the Underreaction syndrome - the child who is unforthcoming, withdrawn and depressed. Withdrawal, depression and maladaptive behaviour to classroom peers were much more common among those twins discharged from hospital after the cotwin. A major mediating factor was that the parents admitted to greatly preferring the one to come home first. These raise questions both about the practice of bringing twins home separately (which occurred in 21% of the cases) and about intervening variables in studies of personality and temperament.

Suicide is a complex problem and a phenomenon of mankind which is obviously influenced by a multitude of ethnological, socio-cultural, psychological and various other factors.

That a man takes his own life does not necessarily mean that he was mentally abnormal. On the other hand, it is a well established fact that the frequency of mental illness — affective disorders in particular — is high among suicides, and that one in six patients suffering from manic-depressive psychosis will commit suicide (Sainsbury, 1968). A family history of suicide is not quite uncommon, and beforehand one cannot exclude the possibility that somehow genetic factors may play a part in suicide; but evidence in favour of such an assumption seems to be scanty.

A survey of the literature reveals that there have been very few twin studies of suicide, and so far concordance in MZ twins seems to have been reported in three cases only.

The first case was observed, already in 1812, by a Dr. Stephens Williams from Massachusetts. He described twin brothers, presumably MZ, who both were captains and had distinguished themselves in the War of Independence. One of the twins settled down in the beautiful state of Vermont, whereas the other remained in Springfield. For several years, they continued to live apart, until, within short interval, they both committed suicide by cutting their throat. Williams points out that the mother and two siblings of the twins had presented symptoms of mental illness, and that, prior to their death, both had been in a state of melancholy, probably an endogenous depression.

Most population studies of twins estimate the number of monozygotic (MZ) and dizygotic (DZ) pairs by Weinberg's differential rule. This rule assumes that within the DZ twins the numbers of unlike-sexed (U) and like-sexed (L) twins are equal. The literature on the validity of Weinberg's rule is still controversial. In this prospective population-based study (EFPTS) of 2,589 twin pairs, of whom 2,577 were of known zygosity and placentation, the estimates of Weinberg's rule agree well with the results of direct zygosity determination.

A method is presented for partitioning the variance associated with human smoking behavior into additive genetic, nonadditive genetic, prenatal environmental, postnatal familial environmental, and postnatal extrafamilial environmental components. Estimations can also be made of additive genetic and residual correlations between spouses and of the correlation between parental additive genetic effect and progeny nonadditive genetic and environmental effect. The variance estimates are free of the biases that might result from these correlations. The statistical genetic analysis is being applied to a large group of MZ and DZ twins, their spouses, and their adult children who live in southern Sweden. Blood samples from each subject will be used to identify their genetic constitution for a number of biochemical polymorphisms, some of which may be considered a priori to have possible relationships to smoking. Associations and genetic linkages between biochemical marker loci and quantitative behavioral traits will be sought. Traits of interest include a wide array of tobacco-use variables, motives for smoking, personality and cognitive variables, and other variables associated with drug use and health. Zygosity determinations based on biochemical polymorphisms have indicated MZ to DZ and DZ to MZ misclassification rates of 0% and 6.15%, respectively, when based solely on external morphology and questionnaire data. The nonpaternity ratio of the fathers with respect to their supposedly biological children is estimated to be 0.28%. Gene frequency estimates for 21 marker loci show that the sample of twins and their relatives is quite representative of the Swedish population at large. All loci were in Hardy-Weinberg-Castle equilibrium, with no evidence of assortative mating for biochemical traits. The MZ twins are significantly more concordant than the DZ twins with respect to whether they have ever had a smoking habit.

Intrauterine death of one fetus in a multiple gestation is associated with significant morbidity and mortality in the surviving infant. This study is a retrospective review of 38 twin and 3 triplet gestations involving the intrauterine death of at least one fetus. The obstetrical history, placental pathology, autopsy findings, and neonatal history of the surviving infant are reviewed. Three cases involved the recent stillbirth of both twins, the remaining cases involved a surviving infant. In one case, neonatal death of a surviving twin occurred on day 19. In two sets of triplets, two stillbirths occurred, in the third case two infants were liveborn. The incidence of preterm delivery was 34%, which decreased to 18% if fetal cotwin death had occurred before 20 weeks gestation. Cesarean section was the method of delivery in 16 cases. There was an excess of velamentous cord insertions, which was most pronounced in the stillborn twin. Monochorionic placentation was found in 72%, also an excess.

Neurological damage was known to have occurred in 19 of the 39 surviving infants. Fifteen of these 19 (79%) were associated with monochorionic placentation. The neurologically damaged twin infants, when compared to the normal infants, had the cotwin die later in gestation (31 vs 16.5 weeks), had a shorter duration between the death of the cotwin and delivery (2.5 vs 21 weeks), and delivered earlier in gestation (36.5 vs 39.5 weeks). The probable cause of neurological damage, in our opinion, was either exsanguination into the dead twin fetus, or disseminated intravascular coagulation which occurred in at least 13 cases. The incidence of antepartum death in a multiple gestation, and the potential for neurological damage is probably higher than previously thought. A review of the literature is presented and the clinical implications of this phenomenon are discussed.

Serial ultrasound examinations have demonstrated that one of two gestational sacs in a twin pregnancy may often disappear. When it disappears at an early stage of gestation, the pregnancy may advance without any disturbance and the cotwin can be delivered well developed and lively. When the intrauterine death occurs in the second trimester, the dead fetus usually results in a fetus papyraceus and the cotwin continues to be alive near term. However, when death occurs in the last trimester, the viable twin may be spontaneously delivered soon and be premature. In some cases of late fetal death, the dead fetus may induce intravascular thromboses in many organs of the surviving cotwin, so that the living infant may develop cerebral palsy later after birth.

Information about menstrual cycle variables was obtained by questionnaire using 462 female twin pairs. The twins were either members of the Institute of Psychiatry Volunteer Twin Register, or of the Birmingham Population-based Register. The two samples were analysed separately using univariate and multivariate methods so that an independent replication was obtained. Maximum likelihood estimation was used to fit simple models of genetic and environmental variation to these data. The results suggest that age of menarche, menstrual cycle regularity and premenstrual symptom reporting may be heritable, whereas menstrual cycle length is not. The results should be interpreted with caution as not all variables were replicated in the smaller sample, and the method of retrospective menstrual cycle data collection has been questioned.

Establishment of the Kaiser- Permanente Twin Registry permitted the study of disease heritability in twins based on review of the twins' medical records. The records of 930 pairs of twins were reviewed. Based on previous questionnaires, 342 pairs were MZ, 345 were DZ and 243 were of unknown zygosity. Because of the age distribution of these twins and the time period in which they received care, conditions of youth, such as acne vulgaris were most reliably studied Heritability of acne was assessed in three ways; all indicated a substantial genetic influence. Certain problems with twin studies using medical records became apparent: 1) Zygosity information is often lacking; 2) Differing times and durations of observation of the two twins in each pair must be accounted for; 3) Categorization by diagnosis is difficult and strict criteria for diagnosis may be impractical; 4) Patients' behavior that affects assessment of disease concordance must be considered; 5) The order in which records are reviewed may influence apparent concordance.

A randomized controlled trial of periconceptional multivitamin supplementation (including 0.8 mg folic acid – see the Materials and Methods section for the precise composition of the multivitamin and trace-element supplementation) was carried out for at least 28 days before conception. The trial was continued until at least until the second missed menstrual period to test the effectiveness of this new primary preventive method in the reduction of neural tube defects. However, other pregnancy outcomes were also evaluated. Of a total of 5,502 pregnant women, 4,846 births were analysed in the final data base. The rate of multiple births was significantly higher in the multivitamin group (3.8%) than in the placebo-like trace-element control group (2.7%), and in both groups exceeded the multiple birth rate of 2.2% in the Hungarian population at large. 7.3% of women in the multivitamin and 7.9% of women in the trace-element groups had received ovarian stimulation treatment (mainly clomiphene) for hormonal dysfunctions, eg. anovulation. Nonetheless, our study showed that periconceptional multivitamin supplementation, with or without ovarian stimulation, increases the rate of multiple births.

The comparison of MZ-DZ twins in behavioral genetics has produced what seems like irrefutable evidence for the heritability of many psychiatric disorders. But such research depends on the validity of the EEA – the “equal environments assumption” – as an underlying premise. In this paper, several empirical studies which support the EEA are critically reviewed in terms of methodology and the way data has been processed in a mathematical model called “path analysis”. It turns out that studies investigating the EEA appear to be largely inadequate in terms of technique, as well as biased in the inferences drawn. Further, the “heritability” estimate – often taken to mean the influence of trait – specific genes – is merely a statistical abstraction derived from a matrix of correlations; this estimate encompasses many buried environmental effects so that “heritability” does not correspond to any underlying DNA structure. In conclusion, many MZ-DZ pedigree studies have dubious scientific value, given the non-viable premise of the EEA, as well as the misleading operational definition of what has been called “heritability”.

A newly discovered case of heteropaternal superfecundation (HS) is reported. Three HS cases were found in a parentage test database of 39,000 records. The frequency of HS among dizygotic twins whose parents were involved in paternity suits is 2.4%. Although the study population appears similar to the general population with respect to twinning data, inferences about the frequency of HS in other populations should be drawn with caution.

In addition to centile curves for birth weight and height of single infants, the authors offer similar biometric references for twins derived from a large French data base. The aim of the work is to assist in discovering small-for-date twins. In the actual prenatal environment, the curves show a decrease in the evolution of these growth parameters in comparison with the single pregnancy standards as early as the 30th week of pregnancy.