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Increased risk of small intestinal atresia among twins in the United States
J D Cragan1, M L Martin, G D Waters
1Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
Objective:
To compare the prevalence of small intestinal atresia among twins and singletons in the United States.
Design:
Descriptive analysis.
Measurements:
The McDonnell Douglas Health Information System (MDHIS), a national registry of newborn diagnoses, 1982 through 1988; and the Metropolitan Atlanta Congenital Defects Program (MACDP), a registry of defects among infants in Atlanta, 1968 through 1989.
Patients:
Live-born infants with small intestinal atresia.
Interventions:
None.
Main Results:
In both systems, the rate of small intestinal atresia was higher among twins than singletons (MDHIS: 5.5 per 10,000 vs 2.0, relative risk [RR] = 2.8, 95% confidence interval [CI] = 1.9 to 4.0; MACDP: 7.3 vs 2.5, RR = 2.9, 95% CI = 1.5 to 5.7). The increase was more notable among same-sex twins than opposite-sex twins, suggesting an increase among monozygotic twins. It was also more notable among twins with jejunoileal atresia than those with duodenal atresia, suggesting a vascular cause in many cases.
Conclusion:
Twins have a higher rate of small intestinal atresia than singletons, possibly due to vascular disruption in monozygotic twins.