BMJ 1999;319:517 ( 21 August )

Letters

Twins and the fetal origins hypothesis

    Many variables differ between twins and singleton infants
    Patterns of growth retardation differ in twins and singletons
    Fetal insult may cause vascular changes and growth retardation
    Authors' reply

Many variables differ between twins and singleton infants

The first 150 words of the full text of this article appear below.

EDITOR---Williams and Poulton report that their 22 adolescent twins had lower blood pressure than singletons.1 They interpret their data as being contrary to the fetal origins hypothesis because they presume that twins, being small at birth, would tend to have higher rather than lower blood pressure in later life. As twins have different patterns of fetal growth from singletons, however, they were specifically excluded from the fetal origins hypothesis.2

There are several reasons why the low birth weight of twins may not have the same significance as intrauterine growth retardation in singleton births. Ultrasound evidence suggests that twins down regulate their growth rate early in gestation, possibly during the first trimester.3 Studies in fetal lambs suggest that early down regulation of fetal growth protects against growth retardation induced by undernutrition in later gestation.4 Finally, the metabolic and endocrine changes associated with growth retardation in singleton infants, including hypoinsulinaemia, are . . . [Full text of this article]
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This article has been cited by other articles:

  • Lawlor, D. A., Hubinette, A., Tynelius, P., Leon, D. A., Smith, G. D., Rasmussen, F. (2007). Associations of Gestational Age and Intrauterine Growth With Systolic Blood Pressure in a Family-Based Study of 386 485 Men in 331 089 Families. Circulation 115: 562-568 [Abstract] [Full text]  
  • Skidmore, P. M.L., Cassidy, A., Swaminathan, R., Falchi, M., Spector, T. D., MacGregor, A. J. (2006). Intrauterine, Environmental, and Genetic Influences in the Relationship Between Birth Weight and Lipids in a Female Twin Cohort. Arterioscler. Thromb. Vasc. Bio. 26: 2373-2379 [Abstract] [Full text]  
  • Lawlor, D. A., Clark, H., Smith, G. D., Leon, D. A. (2006). Intrauterine Growth and Intelligence Within Sibling Pairs: Findings From the Aberdeen Children of the 1950s Cohort. Pediatrics 117: e894-e902 [Abstract] [Full text]  
  • Zhang, J., Brenner, R. A., Klebanoff, M. A. (2001). Differences in Birth Weight and Blood Pressure at Age 7 Years among Twins. Am J Epidemiol 153: 779-782 [Abstract] [Full text]  
  • Aviv, A. (2001). Hypothesis : Pulse Pressure and Human Longevity. Hypertension 37: 1060-1066 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

Fetal growth retardation in twins
Jaakko Kaprio
bmj.com, 30 Aug 1999 [Full text]
The blood pressure of heavier and lighter twins: support for the fetal origin hypothesis?
Yin Bun Cheung
bmj.com, 27 Oct 1999 [Full text]
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