Dizygotic (DZ) World War II veteran twins who participated in the National Heart Lung and Blood Institute (NHLBI) Twin Study have been reported to have greater variance than monozygotic (MZ) twins for plasma high-density lipoprotein cholesterol (HDL-C), cholesterol in the low-density fraction of HDL (HDL2-C) and apolipoprotein A-I, a major protein component of HDL. It was hypothesized that a possible source of this difference in zygosity variance could be prenatal environmental influences related to placental type. Dermatoglyphics were used to provide a retrospective index of placental type in a subset of the NHLBI MZ twins aged 59-70. The MZ twins classified as dichorionic were found to have significantly greater within-pair variability than the monochorionic MZ twins for HDL-C, HDL2-C and Apo A-I. These findings indicate that intrauterine environmental influences on HDL are manifest later in life.

A histomorphological study of the amniotic membranes in full-term twins with double and single placenta was carried out by means of the silver impregnation staining technique suitably modified. Specimens of interface of amniotic membranes were prepared by means of sections. The constant presence of a tubelike structure was observed. Proceeding from the amniotic cavity, the following histological layers were noted: 1) single layer of amniotic cells; 2) amorphic substance with fibrocytes; 3) single layer of endothelial cells. The same order of single layer is present in the amniotic membrane of the second fetus. This tubelike structure is present only in cases of twins with double placenta. If the placenta is single with two umbilical cords, the tubelike structure is not present and only a central amorphic substance surrounded by two single layers of amniotic cells is observed, to confirm the single embryogenetic derivation (monovular). Therefore, through this histological method, we can recognize the true single placenta of twin pregnancy from the pseudosingle placenta so said for the presence of adherences of adjoining surfaces that make it appear single. On the contrary, by manual dissection it is possible to identify a twin pregnancy with two placentae. From the physiological point of view, the walls of the tubelike structure have probably the function to realize exchanges of amniotic liquids between the two fetuses, so as to obtain a balance of electrolytic ions and of intercavity pressure. Growth factors (vascular endothelial factor) are probably involved in the genesis of the endothelial tubelike structure.

A total of 178 placentas of twins born in Tokyo in 1961-1982 were examined. Only just over one third were dichorionic, 110 being monochorionic and DZ twins were estimated to account for 24.7% of the pairs. The lower frequency of DZ twinning in Japan is attributed to lower gonadotropin values in Japanese women as compared to European, American, or African women. High fetal morbidity was found in monochorionic twins and this is attributed to a frequent occurrence of vascular anastomoses.

The low birthweight of twins compared with singletons is only slightly influenced by the higher congenital abnormality rate in twins, or the increased incidence of proteinuric pre-eclampsia in the mothers. Reduced intakes of energy food or of zinc, copper, and iron do not account for the lower birthweight. The main cause of low birthweight is preterm delivery, and this is more common in monozygotic than dizygotic twin pregnancies, due particularly to premature rupture of the membranes. The type of placentation did not influence the preterm onset of labor. Preterm labor in monozygotic twin pregnancies is associated with a very high boy:girl ratio, but this did not apply in dizygotic twin pregnancies.

Twin methodology for the analysis of continuously distributed traits is presented as a guideline for initial steps in the analysis of twin data. Tests for heterogeneity of twin means and variances are reviewed along with estimates of genetic variance.

Analysis of twin data appears on the surface to be a rather simple task, but investigators may well be confused by the wealth of choices available for hypothesis testing. This paper is designed to help the less experienced investigator, with perhaps a modest amount of data, begin analysis with maximum attention to testing all testable assumptions of the twin model, and using recent examples of applications of the methods.