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Can Birthweight Discordancy Within Monozygotic Twin Pairs Be Used as an Indicator of Chorionicity?

Published online by Cambridge University Press:  21 February 2012

Marij Gielen ,
Catherine Derom ,
Robert Derom ,
Robert Vlietinck  and
Maurice P. Zeegers
Marij Gielen*
Affiliation:
Department Complex Genetics, Cluster of Genetics and Cell Biology, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, the Netherlands; Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, United Kingdom. [email protected]
Catherine Derom
Affiliation:
Department for Human Genetics, Faculty of Medicine, Catholic University of Leuven, Belgium.
Robert Derom
Affiliation:
Association for Scientific Research in Multiple Births, Destelbergen, Belgium.
Robert Vlietinck
Affiliation:
Department for Human Genetics, Faculty of Medicine, Catholic University of Leuven, Belgium.
Maurice P. Zeegers
Affiliation:
Department Complex Genetics, Cluster of Genetics and Cell Biology, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, the Netherlands; Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, United Kingdom.
*
*Address for correspondence: Marij Gielen, Department of Complex Genetics, Cluster of Genetics and Cell Biology, Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht University, Universiteitssingel 50 Box 616, 6200 MD Maastricht, The Netherlands.

Abstract

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Both zygosity and chorionicity provide important information in twin research. The East Flanders Prospective Twin Survey (EFPTS) determines zygosity and chorionicity at birth and therefore provides a gold standard for the testing of diagnostic parameters that can be used to determine chorionicity. The aim of the present study was to investigate whether birthweight discordancy can be used as an indicator of chorionicity. The study sample consisted of 4,060 live-born twin pairs from the EFPTS. We studied MZ twins, using univariate and multivariate logistic regression analyses to calculate odds ratios (OR) and 95% confidence intervals (CI) of being MC in relation to discordancy level. Diagnostic parameters, including sensitivity and specificity, were calculated. A two-fold cross-validation was carried out and a bootstrap distribution with 10,000 samples was created to estimate the standard deviations. For discordancy levels of below 10%, 10–15%, 15–20%, 20–25% and above 25%, the ORs (95% CI) were 1.16 (0.91–1.47), 1.38 (1.05–1.80), 2.13 (1.51–3.01), 2.73 (1.73–4.29) and 2.81 (2.81–4.35) respectively. There were no gender differences. Sensitivity was 42.2% (SD 5.6%), specificity was 72.8% (SD 6.3%), positive predictive value was 72.8% (1.5%) and the negative predictive value was 39.2% (0.7%). In conclusion, although a higher discordancy level resulted in higher ORs of being an MC twin, birthweight discordancy level can only be used to some weak extent as a proxy for chorionicity, highlighting the need to assess and record chorionicity data in obstetrical units.

Keywords

birthweight discordancychorionicityzygositydiagnostic testsensitivityspecificity
Type
Articles
Information
Twin Research and Human Genetics , Volume 12 , Issue 2: SPECIAL SECTION: Genes for Health Meeting 2009 , 01 April 2009 , pp. 169 - 174
Copyright
Copyright © Cambridge University Press 2009