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Related Experiment Videos

Why do small twins have a lower mortality rate than small singletons?

P Buekens1, A Wilcox

  • 1Department of Epidemiology and Social Medicine, School of Public Health, Free University of Brussels, Belgium.

American Journal of Obstetrics and Gynecology
|March 1, 1993
PubMed
Summary

The survival advantage for low-birth-weight twins is an illusion. After adjusting for birth weight, twins face higher mortality risks than singletons, regardless of weight.

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Area of Science:

  • Perinatal epidemiology
  • Twin studies
  • Neonatal survival analysis

Background:

  • Low-birth-weight infants often have poorer survival rates.
  • Previous observations suggested twins with low birth weight had a better survival rate than singletons with low birth weight.

Purpose of the Study:

  • To investigate the paradox of higher survival rates in low-birth-weight twins compared to low-birth-weight singletons.
  • To determine if the apparent survival benefit for twins persists after accounting for relative birth weight.

Main Methods:

  • Utilized Belgian birth and death certificate data from 1983-1984.
  • Included 229,964 singletons and 4,328 twins (first and second).
  • Compared weight-specific perinatal mortality rates, adjusting birth-weight distributions to a common mean and standard deviation.

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Main Results:

  • Adjusted mortality rates were higher for twins than singletons across all weight categories.
  • The observed better survival for small twins disappeared upon statistical adjustment.

Conclusions:

  • The apparent survival advantage for low-birth-weight twins is an artifact of relative birth weight.
  • Twinning itself confers a significant mortality risk to all twins, irrespective of their individual birth weight.