Twin Research

Articles

Cardiovascular Mortality in Twins and the Fetal Origins Hypothesis

Kaare Christensena1 c1, Andreas Wienkea2, Axel Skytthea3, Niels V. Holma4, James W. Vaupela5 and Anatoli I. Yashina6

a1 The Danish Twin Registry, University of Southern Denmark, Denmark; Danish Center for Demographic Research, University of Southern Denmark, Denmark. kchristensen@health.sdu.dk

a2 Max Planck Institute for Demographic Research, Rostock, Germany.

a3 Danish Center for Demographic Research, University of Southern Denmark, Denmark.

a4 The Danish Twin Registry, University of Southern Denmark, Denmark.

a5 Max Planck Institute for Demographic Research, Rostock, Germany.

a6 Max Planck Institute for Demographic Research, Rostock, Germany.

Abstract

The intrauterine growth patterns for twins are characterized by normal development during the first two trimesters and reduced growth during the third trimester. According to the fetal origins hypothesis this growth pattern is associated with risk factors for cardiovascular morbidity and mortality. We studied cause-specific mortality of 19,986 Danish twin individuals from the birth cohorts 1870–1930 followed from 1952 through 1993. Despite the large sample size and follow-up period we were not able to detect any difference between twins and the general population with regard to all-cause mortality or cardiovascular mortality. Hence, the intrauterine growth retardation experienced by twins does not result in any “fetal programming” of cardiovascular diseases. There is still an important role for twins (and other sibs) to play in the testing of the fetal origins hypothesis, namely in studies of intra-pair differences, which can assess the role of genetic confounding in the association between fetal growth and later health outcome.

Correspondence:

c1 Address for correspondence: Kaare Christensen, MD, PhD, The Danish Twin Registry, University of Southern Denmark, Sdr. Boulevard 23A DK-5000 Odense C, Denmark.

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