Document Detail

Twinning and cerebral palsy: experience in four northern California counties, births 1983 through 1985.
MedLine Citation:
PMID:  8233749     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Twinning is associated with heightened risk of cerebral palsy (CP) and is increasing in the United States and elsewhere. METHODS: Twins with moderate or severe congenital CP were identified in a cohort of 155,572 children born 1983 through 1985 in four northern California counties and surviving to 3 years. The prevalence of CP in twins and factors associated with increase in risk were examined. RESULTS: Among 2985 twins, 20 children in 18 pairs had CP. The prevalence of CP was 6.7 per thousand 3-year-old twin children (95% confidence interval [CI], 4.2 to 11), 12 per thousand twin pregnancies (95% CI, 7.2 to 19), and 1.1 per thousand singletons (95% CI, 0.97 to 1.3). Ten percent of all CP was in twins; 22% of CP in infants of less than 1500 g birth weight occurred in twins. Twins were over-represented among very low birth weight infants but their risk of CP was comparable with that of very low birth weight singletons. Twins born weighing 2500 g and more had a CP risk 3.6 times that of singletons of similar weight. In children who survived fetal death of a co-twin, CP was 108 times more prevalent (95% CI, 42 to 273) than in singletons and 13 times more prevalent (95% CI, 4.5 to 37) than in twins whose co-twin was born alive. The CP rate in unlike-sex pairs was 13 per thousand (95% CI, 4.8 to 32), not significantly different from 11 per thousand (95% CI, 5.7 to 19) for like-sex pairs. CONCLUSION: Twin pregnancies produced a child with CP 12 times more often than singleton pregnancies. The heightened risk was largely related to the tendency of twins to be low in birth weight and to a greater risk of CP in twins of normal birth weight compared with singletons of similar weight. Twins of unlike-sex pairs, necessarily dizygotic, were not at lower risk than like-sex pairs. The current increase in multiple births is likely to contribute more children with CP.
J K Grether; K B Nelson; S K Cummins
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  92     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1993-12-22     Completed Date:  1993-12-22     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  854-8     Citation Subset:  AIM; IM    
California Dept of Health Services, California Birth Defects Monitoring Program, Emeryville 94608.
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MeSH Terms
California / epidemiology
Cerebral Palsy / congenital,  epidemiology*
Diseases in Twins*
Infant, Low Birth Weight
Infant, Newborn
Grant Support
MCJ 002001-28-0//PHS HHS

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