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Twins and Necrotizing Enterocolitis: Genetic Relevance.

Vineet Bhandari1

  • 1Division of Neonatology, Department of Pediatrics, The Children's Regional Hospital at Cooper, Camden, NJ08103, United States.

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|February 14, 2025
PubMed
Summary

Necrotizing enterocolitis (NEC) in preterm infants may be influenced by genetic and environmental factors, particularly in twins. Further research with larger cohorts is needed to clarify these complex NEC causes.

Keywords:
NECgenetics.gut microbiomemonochorionicpreterm infant

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Area of Science:

  • Neonatal intensive care unit (NICU) research
  • Pediatric gastroenterology
  • Twin studies in neonatology

Background:

  • Necrotizing enterocolitis (NEC) is a severe complication in preterm infants, leading to significant short- and long-term issues.
  • Higher NEC incidence in monochorionic twins suggests abnormal placental vascular connections, but genetic and environmental factors are also implicated.
  • Existing research presents conflicting data on NEC incidence differences between singletons and twins when gestational age is controlled.

Purpose of the Study:

  • To critically appraise published literature on twin studies to determine the genetic relevance of necrotizing enterocolitis (NEC).
  • To evaluate the role of genetic, environmental, and gut microbiome factors in NEC pathogenesis in preterm infants.

Main Methods:

  • Mini-review of published literature focusing on twin studies related to necrotizing enterocolitis (NEC).
  • Analysis of existing data on zygosity, same-sex concordance, and fecal microbiome in preterm twins.
  • Appraisal of studies controlling for gestational age to compare NEC incidence in singletons and twins.

Main Results:

  • Twin studies suggest shared genetic and environmental factors contribute to NEC, supported by microbiome data.
  • Monochorionic twins may have an increased incidence of NEC, often linked to placental vascular abnormalities.
  • Some studies controlling for gestational age found no significant difference in NEC occurrence between singletons and twins.

Conclusions:

  • The genetic relevance to NEC requires further investigation through comprehensive twin studies.
  • Confounding factors, including environmental influences and the gut microbiome, warrant deeper evaluation in larger infant cohorts.
  • Clarifying the multifactorial etiology of NEC in preterm infants is crucial for improving outcomes.