Disease relevance of Multiple Birth Offspring

• METHODS: We used data from a population-based cohort study from which we assessed the occurrence of multiple births in women (n=242015) who had participated in a campaign to prevent neural tube defects with folic acid supplements (400 microg per day) in China. Folic acid use was ascertained before pregnancy outcome was known [1].
• Folic acid supplementation and the occurrence of congenital heart defects, orofacial clefts, multiple births, and miscarriage [2].
• Early studies suggested that periconceptional multivitamin use was associated with an increased occurrence of both miscarriages and multiple births, which has resulted in a great deal of controversy about the safety of folic acid use during pregnancy [2].
• A rapid evolution mechanism may contribute to changes in sex ratio, multiple birth incidence, frequency of auto-immune disease and frequency of birth defects in Clomid conceptions [3].

High impact information on Multiple Birth Offspring

• CONCLUSIONS: Based on these data, the risk of multiple births from IVF varies by maternal age and number of embryos transferred [4].
• Results of some studies, however, suggest an increase in multiple births associated with use of vitamin supplements that contain folic acid during pregnancy [1].
• Townes-Brocks syndrome (TBS, OMIM #107480) is an autosomal dominant disorder that causes multiple birth defects including renal, ear, anal and limb malformations [5].
• Further, the reduction in risk seemed to diminish with increasing parity, and among women with 4 or more full-term pregnancies, ever having had a multiple birth was associated with an elevated risk (IRR = 1.48, 95% CI = 0.97-2.25) [6].
• After multiple birth, newborn plasma SS, but not plasma CCK, was significantly lower than after single birth (9.1 +/- 7.7 versus 16.9 +/- 12.7 pmol/L) [7].

Biological context of Multiple Birth Offspring

• OBJECTIVE: To examine associations between the number of embryos transferred during IVF and live-birth and multiple-birth rates stratified by maternal age and whether extra embryos were available (ie, extra embryos cryopreserved) [4].
• The probability of multiple births when multiple gestational sacs or viable embryos are diagnosed at first trimester ultrasound [8].
• In the context of the day-to-day variability in diabetes "control" of the poorly regulated mother, and the relatively longer duration of organogenesis, these multifactorial possibilities may account for the multiple birth defects that can occur in individual offspring, and the seemingly non-specific pattern of diabetic embryopathy [9].
• Other factors associated with earlier administration of the initial surfactant dose were gestational age, lower 1-minute Apgar score, cesarean delivery, antenatal steroid treatment, multiple birth, and small size for gestational age [10].
• PURPOSE: The concordance of strabismic phenotypes was examined in monozygotic versus multizygotic twins and other multiple births to study the role of genetic background in different types of commitant strabismus [11].

Anatomical context of Multiple Birth Offspring

• RESULTS: Cord blood red cells of multiple birth premature infants were more hemolysis-resistant than erythrocytes from full-term infants or adults [12].

Associations of Multiple Birth Offspring with chemical compounds

• The multiple birth rate for clomiphene-HMG (7/21) equalled that for HMG alone (3/12) and HMG and clomiphene together (3/8) [13].
• Therefore, daily estrogen determinations from the 1st day of treatment are mandatory in order to avoid hyperstimulation and/or multiple births [14].
• The mothers with the dizygotic multiple births were on moderate to elevated levels of heroin or methadone at the time of conception [15].
• Comparison with the most recent published national data relating to birthweight specific survival of very low birthweight singleton and multiple births suggests that the downward trend of mortality is continuing, at least in this Region [16].
• The effectiveness of dexamethasone was analyzed with respect to the condition of the infant at delivery, the mode of delivery, and multiple births [17].

Gene context of Multiple Birth Offspring

• These results have clinical implications in managing the entire multiple birth family where one twin has ADHD, and also has implications for genetic analysis in modeling the relationship of ADHD to internalizing disorders [18].
• PATIENTS AND METHODS: Cord blood samples were obtained from preterm singletons (N=11), preterm multiple births (N=10), full-term infants (N=24), as well as adults (N=22), for comparison [12].
• This study evaluated genetic and developmental contributions to epilepsy, using data on epilepsy and multiple births in the sibships of 1981 probands with epilepsy [19].
• Since these PRL surges may be regulated in part by endogenous opioids and opioid sensitivity declines as a function of multiple births, we decided to investigate the possibility that prior parity might affect the post-coital diurnal and nocturnal PRL surges, reducing their magnitude and/or occurrence [20].
• The immediate, or "stat", autopsy is a diagnostic modality involving the use of multiple procedures for the rapid diagnosis of perinatal infection which may be lifesaving in the setting of multiple birth neonates [21].

Analytical, diagnostic and therapeutic context of Multiple Birth Offspring

• Data from 6,936 IVF procedures performed in the United States in 1996-1997 on women aged 35-54 years who used donor eggs were analyzed to assess the effect of maternal age, number of embryos transferred, and cryopreservation of extra, nontransferred embryos (an indicator of higher embryo quality) on risk of multiple birth [22].
• Neurological sequelae and multiple birth defects have been observed in children conceived by IVF and ICSI [23].
• Mean serum estradiol levels were significantly higher when ultrasonography was used to monitor response, but complications such as multiple births and ovarian enlargement did not occur more often [24].
• CONCLUSIONS: The increased hospitalization of IVF children is, to a large extent, due to the increased incidence of multiple births [25].

References