How to cite this article: Hardin J, Carmichael SL, Selvin S, Lammer EJ, Shaw GM. 2009. Increased prevalence of cardiovascular defects among 56,709 California twin pairs. Am J Med Genet Part A 149A:877–886.
Increased prevalence of cardiovascular defects among 56,709 California twin pairs†
Article first published online: 7 APR 2009
Copyright © 2009 Wiley-Liss, Inc.
American Journal of Medical Genetics Part A
Volume 149A, Issue 5, pages 877–886, May 2009
How to Cite
Hardin, J., Carmichael, S.L., Selvin, S., Lammer, E.J. and Shaw, G.M. (2009), Increased prevalence of cardiovascular defects among 56,709 California twin pairs. Am. J. Med. Genet., 149A: 877–886. doi: 10.1002/ajmg.a.32745
- Issue published online: 23 APR 2009
- Article first published online: 7 APR 2009
- Manuscript Accepted: 7 JAN 2009
- Manuscript Received: 16 JUL 2008
- cardiovascular diseases;
- congenital heart defect;
This study compared the prevalence of cardiovascular defects in twin and singleton births and explored the influences of zygosity (monozygotic and dizygotic) and maternal age (<35 and ≥35 years of age) on concordance. Data on twin and singleton infants with (n = 628 twin pairs and n = 14,078 singletons) and without (n = 53,974 twin pairs and n = 4,858,255 singletons) cardiovascular defects were obtained from the California Birth Defects Monitoring Program and the California vital statistics birth and fetal death records during the period 1983–2003. Prevalence ratios (PR) (prevalence of twin/singleton) and approximate 95% confidence intervals were calculated for 16 congenital cardiovascular categories. Poisson regression techniques using log-linear models were employed to assess whether the probability of concordance of defects within each cardiovascular category varied by zygosity or maternal age. An increased prevalence was observed in twins compared to singletons in all 16 cardiovascular categories. Seven of the cardiovascular categories had at least double the prevalence in twins compared to singletons. Like-sex twins, as a proxy of monozygosity, had an increased prevalence of cardiovascular defects compared to unlike sex twins. Probabilities of concordance for flow lesions were higher among monozygotic than dizygotic twins. Our study provides evidence that twinning is associated with more cardiovascular defects than singletons. Increased concordance for flow lesions in monozygotic twins was observed, an observation that is in agreement with findings from familial recurrence studies of cardiovascular defects. © 2009 Wiley-Liss, Inc.