Oesophageal atresia in twins

Abstract

The twin incidence is higher in infants with oesophageal atresia (OA) than in the general population. The purpose of this study was to review the twin OA information from five institutions and evaluate possible links between the development of OA and the twinning process. Data were compared, combined, and analysed. There was a total of 1,215 infants with OA, of whom 50 were from a twin pregnancy and 1 from a triplet pregnancy. Two sets of twins were concordant for OA. Mean birth weights and gestational ages were lower in the twin infants (P < 0.0005) and survival was lower in twins (65%, P < 0.005) than singletons. The anatomical variant of pure OA without fistula was seen in proportionally fewer twins (4%) than in singletons (7%). Multiple anomalies were present in 40% of twins compared with 33% of singletons, although this did not reach statistical significance. OA in our multicentre population was more common in twins. Several possible mechanisms are put forward to explain the apparent link between twinning and OA. Further analysis of this aspect of OA may aid in understanding the aetiology of this congenital anomaly.

Genetic and environmental factors in the etiology of esophageal atresia and/or tracheoesophageal fistula: An overview of the current concepts

“…However, in three families, the two affected siblings were discordant with respect to the presence of a TEF (one sibling had EA only, the other EA and TEF), despite the fact that in one of the families the children had a mother with EA/TEF (Dennis et al, 1973;Pletcher et al, 1991;McMullen et al, 1996). Similarly, for affected twins, most sets of twins are concordant and only one report describes twins with a difference in EA/TEF subtypes (EA only and EA/TEF) (Woolley et al, 1961;Blank et al, 1967;King et al, 1977;Ohkuma, 1978;Whalen et al, 1987;McMullen et al, 1996;Ishimaru et al, 1998;Orford et al, 2000;Farquhar et al, 2002;Trobs et al, 2006). The fact that different types of EA/ TEF can occur within one family suggests (at least partly) overlapping etiologies.…”

Early developmental outcome following surgery for oesophageal atresia

“…3,4 OA occurs between one in 2500-4500 live births, 5 with an increased incidence in twins. 6 While survival of infants with OA continues to improve, there are recognised long-term morbidities, both physical and psychological. [7][8][9] Infants with OA have long-term ongoing physical and nutritional difficulties that may affect their development.…”

Esophageal atresia with tracheoesophageal fistula in both members of monozygotic twins

“…The incidence of EA is generally 1 in approximately 2,500-4,500 births [4,5], whereas in twins, it is known to be three times higher than that in singletons [3]. Further, in patients with EA, the incidence of twinning is higher than statistically expected; usually, EA affects only one of twins [1,6,7].…”

“…It has been reported that esophageal atresia (EA) occurs at an increased rate in twins and usually affects only one of twins [1,2], whereas the occurrence of EA in both members of twins (EABT) is extremely rare [3]. This paper aims to review and summarize the cases of EABT in the literatures, including our cases.…”