Perinatal mortality among twins and singletons in a city in southeastern Brazil, 1984-1996

Beiguelman, B; Franchi-Pinto, Carla

doi:10.1590/s1415-47572000000100003

Cited by 11 publications

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“…Neste contexto, observa-se elevada taxa de mortalidade perinatal em gemelares, fortemente influenciada pelo baixo peso e prematuridade, devido à associação com desordens respiratórias, metabólicas, imunológicas e neurológicas. Soma-se aqui outro aspecto relevante que diz respeito aos índices de Apgar baixos entre os recém-nascidos gêmeos (4,5) . Quanto aos aspectos interacionais, verifica-se que a estreita relação intragemelar pode reduzir a necessidade do desenvolvimento verbal e diminuir a motivação para se comunicar, levando ao aparecimento da chamada linguagem secreta, ou seja, uma comunicação própria entre os gêmeos (6)(7)(8) .…”

Section: Introductionunclassified

Aspectos fonoaudiológicos e pediátricos na linguagem de gêmeos monozigóticos

Barbetta

Panhoca

Zanolli

2008

Rev. paul. pediatr.

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ResumoObjetivo: Observar o discurso familiar a respeito da gemelaridade, por meio de categorias inseridas nas práticas sociais, buscando subsidiar e delinear a contribuição do fonoaudiólogo e do pediatra no desenvolvimento de linguagem dos gêmeos monozigóticos.Métodos: O trabalho apóia-se no método qualitativo de pesquisa e a análise dos dados foi realizada segundo a perspectiva histórico-cultural e o paradigma de natureza indiciária. Em 30 meses, foram realizadas oito entrevistas semi-estruturadas seqüenciais, iniciadas à revelação da gestação gemelar e continuadas em intervalos aproximados de três meses até cerca de dois anos de vida dos gêmeos, com dez famílias que tinham em sua composição direta um par de gêmeos idênticos.Resultados: Sete categorias emergiram nos relatos obtidos com os familiares -a descoberta da gemelaridade, a escolha de nomes, o vestuário, a interação, a rotina, a linguagem e a identidade.Conclusões: Os depoimentos, práticas, valores e pressupostos estão relacionados com o desenvolvimento destas crianças e apontam que essas famílias precisam de um acompanhamento diferenciado e específico, desde o momento gestacional.Palavras-chave: gêmeos monozigóticos; desenvolvimento da linguagem; Pediatria; relações familiares; cuidados médicos. AbstRActObjective: To observe the way families express themselves about twins using categories related to social practices in order to help health care workers to contribute to the development of the speech of monozygotic twins.Methods: The study uses the qualitative method, based on a historic-cultural perspective and the evidential paradigm. During 30 months, eight sequential semi-structured interviews were applied to ten families who had identical twins. The interviews began when the diagnosis of the twin gestation was announced to the families and continued at approximately three-month intervals until the twins were two years old.Results: Seven categories were reported by the families during the interviews regarding the development of their twin children -announcement of the twin pregnancy, choice of names, choice of clothes, pattern of speech and identity of each child, as well as general routine and family interaction.Conclusions: There is a relationship between the development of the language in monozygotic twins and the attitudes and values reported by their families. Families of twins may need specific and differentiated follow-up since the gestational period.

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Section: Introductionunclassified

Aspectos fonoaudiológicos e pediátricos na linguagem de gêmeos monozigóticos

Barbetta

Panhoca

Zanolli

2008

Rev. paul. pediatr.

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“…This is because in addition to perinatal morbidity-mortality risks being greater for multiple births than for singletons, [25][26][27][28] emphasis needs to be placed on the fact that mortality among twins remains significantly higher than among singletons until the age of five years. 29 Thus, in another Brazilian sample, when twins were compared with singletons, the likelihood of stillbirths and early neonatal deaths among twins was 1.9 and 6.5 times greater, respectively.…”

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“…29 Thus, in another Brazilian sample, when twins were compared with singletons, the likelihood of stillbirths and early neonatal deaths among twins was 1.9 and 6.5 times greater, respectively. 28 Since, on average, twins are born three weeks earlier than singletons, 20 while 41.2% of the triplets are born before completing 33 weeks, 4 it is understandable that around 50% of twin births and more than 90% of triplets present low birth weight. Moreover, the frequency of very low birth weight among newborn children that are twins is several times greater than for singletons.…”

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Twinning rate in a sample from a Brazilian hospital with a high standard of reproductive care

Colletto

Beiguelman

2001

Sao Paulo Med. J.

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CONTEXT: Epidemiological studies on twin births have been motivated mostly by the positive correlation between twinning rate and human fertility, prematurity, low birth weight, increased risk of infant death and long term risk for morbidity. OBJECTIVE: This paper intends to estimate the incidence of multiple births in a private hospital in Brazil with a high standard of reproductive care, and to evaluate the effects of maternal age, gestation order and assisted fertilization on twinning rate. DESIGN: Retrospective analysis. SETTING: First-class tertiary private hospital, São Paulo, Brazil. PARTICIPANTS: The multiple birth rate was investigated among 7,997 deliveries from 1995 to 1998, including 7,786 singletons, 193 twins, 17 triplets and one quadruplet. RESULTS: The rates per 1,000 dizygotic and monozygotic pairs and for triplets were estimated as 19.51, 4.50 and 2.13, respectively. The dizygotic and triplet rates were the highest observed in Brazil up to the present day. The twinning rate among primigravidae older than 30 years was very high (45.02 per 1,000) and was due to a disproportionately high frequency of dizygotic pairs. The triplet rate was also very high among the mothers of this age group (5.71 per 1,000). These facts are strong indicators that these women were the ones most frequently submitted to assisted reproductive techniques. The mean maternal age of the studied population was about six years higher than that estimated for mothers in the general population of southeastern Brazil. Primigravidae aged under 30 years as well as multigravidae showed similar twinning rates, which were almost 20 per 1,000. Among the deliveries of multigravidae older than 30 years, an unusually high frequency of monozygotic twins was observed (7.04 per 1,000), probably as a consequence of the residual effect of long-term use of oral contraceptives. CONCLUSIONS: The dizygotic twinning rate increased from 13.51 to 28.98 per 1,000 over the four years studied, with the twinning rate for primigravidae over 30 years old in 1998 being twice that observed in 1995. The mean maternal age was also high during this period, but the extremely high increase in twinning rate observed cannot be attributed solely to this variable. Assisted fertilization seems to be the most probable cause of this unusually high twinning rate.

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“…In Chile, as well as in Latin American and Caribbean countries, twin studies are mainly related to clinical aspects or case studies, and not twin registries (Beiguelman et al, 2000;Briceño & Briceño, 2005;Colletto, 2003;Daher et al, 1991;Daré et al, 1993;Nazer et al, 1999Nazer et al, , 2006 …”

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Chilean School-Age Children Twin Registry: Planning, Sampling and Implications

et al. 2006

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W e describe subject recruitment from the University of Chile School-Age Children Twin Registry (REMEUCHI). The research aim of REMEUCHI is to quantify the impact of genetic and environmental factors on scholastic achievement in a multicausal approach. The Ministry of Education of Chile, in collaboration with the Registry Office, provided the list of possible twin pairs graduated from high school in 2004 in Chile's metropolitan region. From a population of 70,065 school-age children who had graduated from high school, 434 possible twin pairs were analyzed. Of these, 327 were twins reared together (75.3% of the 434 possible twins pairs) and born between 1986 and 1987 in Chile (mean age 18 years), and approximately 8% were not twins despite matches on full name and birth data. The rest of the possible twin pairs were probably twins reared apart, since one member of the pair had moved to study in another region of Chile. Zygosity was determined through questionnaires, maternal reports of twin similarities, and by the hospital records of the twins at the time of birth. Three hundred and twenty-seven pairs were identified, where monozygotic (MZ) and dizygotic (DZ) twins represented 46.8% and 53.2% of pairs, respectively, with a DZ/MZ ratio of 1.14. Considering same-sex MZ pairs, the percentage of female pairs was greater (55.6%) than male pairs (44.4%). When DZ pairs were analyzed, 47.7% were of opposite sex, 20.1% were male pairs and 32.2% female pairs. In Chile, these findings represent a baseline study to contribute to the establishment of a national twin registry in the future.

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Perinatal mortality among twins and singletons in a city in southeastern Brazil, 1984-1996

Cited by 11 publications

References 25 publications

Aspectos fonoaudiológicos e pediátricos na linguagem de gêmeos monozigóticos

Aspectos fonoaudiológicos e pediátricos na linguagem de gêmeos monozigóticos

Twinning rate in a sample from a Brazilian hospital with a high standard of reproductive care

Chilean School-Age Children Twin Registry: Planning, Sampling and Implications

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