Significant management decisions in triplet pregnancies are made based mainly on ultrasound measurements of fetal growth, although there is a paucity of data examining the accuracy of fetal weight measurements in these gestations. To evaluate accuracy of prenatal ultrasound to diagnose growth abnormalities (intrauterine growth restriction, severe growth discordance) in triplet pregnancies, a retrospective cohort study of 78 triplet pregnancies (234 fetuses) delivered at a single tertiary hospital from January 2004 to May 2015 was performed. Growth percentiles from the last ultrasound were derived from estimated fetal weight using Hadlock's formula for each triplet. Growth discordance was calculated for each triplet set using the formula {(estimated fetal weight largest triplet - estimated fetal weight smallest)/estimated fetal weight largest}. These estimations were compared to birth weights. Sensitivity of ultrasound to predict ≥1 growth restricted fetus in a triplet set was 55.6% [95% CI 35.3, 74.5]; specificity was 100% [95% CI 93.0, 100]; positive predictive value (PPV) 100% [95% CI 74.7, 100]; negative predictive value (NPV) 81.0% [95% CI 73.2, 85.7%]. Sensitivity of ultrasound to detect fetal growth discordance >25% in a triplet set was 80.0% [95% CI 44.4, 97.5], specificity 94.1% [95% CI 85.6, 98.4]; PPV 66.7% [95% CI 42.4, 84.5]; NPV 97.0% [95% CI 90.2, 99.1]. Prenatal ultrasound currently remains the most reliable tool to screen for growth anomalies in triplet pregnancies; however, it appears to have less than ideal sensitivity, missing a number of cases of intra-uterine growth restriction and significant growth discordance.

The Wuhan Pre/Post-Natal Twin Birth Registry (WPTBR) is one of the largest twin birth registries with comprehensive medical information in China. It recruits women from the first trimester of pregnancy and their twins from birth. From January 2006 to May 2016, the total number of twins enrolled in WPTBR is 13,869 twin pairs (27,553 individuals). The WPTBR initiated the Wuhan Twin Birth Cohort (WTBC). The WTBC is a prospective cohort study carried out through incorporation of three samples. The first one comprises 6,920 twin pairs, and the second one, 6,949 twin pairs. Both are population-based samples linked to the WPTBR and include pre- and post-natal information from WPTBR. The second sample includes neonatal blood spots as well. Using a hospital-based approach, we recently developed a third sample with a target enrolment of 1,000 twin pairs and their mothers. These twins are invited, via their parents, to participate in a periodic health examination from the first trimester of pregnancy to 18 years. Biological samples are collected initially from the mother, including blood, urine, cord blood, cord, amniotic fluid, placenta, breast milk and meconium, and vaginal secretions, and later from the twins, including meconium, stool, urine, and blood. This article describes the design, recruitment, follow-up, data collection, and measures, as well as ongoing and planned analyses at the WTBC. The WTBC offers a unique opportunity to follow women from prenatal to postnatal, as well as follow-up of their twins. This cohort study will expand the understanding of genetic and environmental influences on pregnancy and twins’ development in China.

The publishers regret to announce that the affiliation for the above paper was incorrectly inserted. The correct affiliation is below:

Aniket Mishra1, Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO) and the Colorectal Cancer Family Registry (CCFR), and Stuart MacGregor1

1 Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia

Twin research in Brazil twin has expanded enormously in recent years, engaging the interests and efforts of many investigators, students and twins. Descriptions and brief summaries of this work and talks given by investigators at local conferences are presented, based on my four-city lecture tour. This is followed by summaries of twin research on infants’ viewing of social scenes, religiosity and substance abuse, Down syndrome, and chronic periodontitis. This article concludes with twin-related news and information of general interest, including identical twin property designers, twins with cerebral palsy, twins affected with the Zika virus, a pair of twin writers, twins in sports, and a set of quadruplets from my childhood neighborhood in Riverdale, New York.

The presence of situs inversus totalis (full reversal of internal organs) in twins is briefly reviewed. Information gathered from 35-year-old monozygotic (MZ) female twin pair discordant for this condition is presented. This is followed by summaries of research on the frequency of trisomy 21 (Down syndrome) in twins, the first case of MZ twin concordance for bilateral coronoid hyperplasia, prenatal hormonal effects in mixed-sex non-human primate litters, and links between insurance mandates and twinning following in vitro fertilization. The final section of this article describes twin-related events reported in the news, namely, the first recorded birth of identical twin puppies; the 100th birthday celebration of a pair of fraternal female twins, the passing of an award-winning identical twin production designer, and the first running of the New York City Marathon by a set of quadruplets.

The late neurologist and author, Oliver Sacks, published an insightful 1986 review of Marjorie Wallace's book, The Silent Twins, in the New York Times. Taking exception to his assertion about Sir Francis Galton, I wrote a letter to the Times’ editor. The letter was unpublished, but it brought a wonderful response from Sacks himself that is reproduced and examined. Next, brief reviews of twin research concerning the vanishing twin syndrome (VTS), discordant sex in a monozygotic (MZ) twin pair, and multiple pregnancy outcomes from assisted reproductive technology (ART) are presented. This section is followed by popular coverage of superfetated twins, smoking-discordant co-twins, twins in fashion, Yale University twin hockey players, and a visiting professor who was a conjoined twin.