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Twin-Singleton Comparisons Across Multiple Domains of Life

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Twin and Higher-order Pregnancies

Abstract

In this chapter, we address the question whether individuals born from a multiple pregnancy differ from singletons. The answer to this question is important for health-care professionals and researchers, as well as multiples themselves and their family members.

First, we review findings from the literature with respect to twin – non-twin differences in early life and conclude that a multiple pregnancy increases the risk of congenital problems and mortality for the unborn and newborn children.

Next, we provide an overview of the outcomes of comparing adult twins to their singleton siblings across a wide range of traits assessed in the Netherlands Twin Register (NTR). In a within-family design, comparing twins to siblings from the same family, we correct for familial confounding. Overall, hardly any evidence was found for the presence of twin-sibling differences for the five domains explored, which included body composition and physical development, personality and psychopathology, behavioral and sociodemographic traits, physiological parameters and physical disease, and cognitive function. With the exception of minor differences in body composition, twins do not seem to differ from singletons, when taking family factors into account.

In conclusion, while being a twin can be seen as special, adult twins are similar to ordinary siblings across most domains of life.

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Authors and Affiliations

  1. Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

    Gonneke Willemsen, Veronika Odintsova, Eco de Geus & Dorret I. Boomsma

  2. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia

    Veronika Odintsova

Authors
  1. Gonneke Willemsen
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  2. Veronika Odintsova
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  3. Eco de Geus
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  4. Dorret I. Boomsma
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Correspondence to Gonneke Willemsen .

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Editors and Affiliations

  1. Fetal Medicine Unit, St George’s University Hospitals, NHS Foundation Trust, London, UK

    Asma Khalil

  2. Department of Obstetrics & Gynaecology, University Hospitals Leuven, Leuven, Belgium

    Liesbeth Lewi

  3. Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands

    Enrico Lopriore

Appendix: Within-Family Twin – Non-Twin Comparisons Across a Wide Range of Traits Assessed in the Netherlands Twin Register

Appendix: Within-Family Twin – Non-Twin Comparisons Across a Wide Range of Traits Assessed in the Netherlands Twin Register

1.1 Participants and Selection Procedure

To compare twins to their siblings, we made use of the data from two separate projects: (1) the eighth NTR survey on health, lifestyle and personality, which was sent out to adult participants between 2004 and 2009 [120, 123]; (2) a large-scale blood collection project carried out between 2004 and 2009 in which participants were visited at home to obtain blood samples and health information [125].

For each of the two datasets, we followed the same procedure. We first selected all twins and their singleton siblings with known age, sex, birth year, and, in the case of twins, zygosity. Known half-siblings and non-biological siblings were excluded. Next, we randomly selected one of the twins in case a twin pair both participated and assessed whether there was a same-sex singleton sibling in the family who was born within 6 years from the twin. This sibling was then selected, if at the time of participating he or she was within 6 years of the age of the twin. In the case multiple singleton siblings of a twin met the criteria, we selected the same-sex sibling closest in birth year. We made two exceptions to this procedure. In the case of an opposite-sex twin pair, when a male twin-sibling pair could be formed in the dataset, we selected the male pair. This was done to maximize the presence of male pairs in the analyses as fewer males participated than females. When both older and younger siblings within the 6-year time frame were present, preference was given to the sibling younger than the twin, as twins more often have older siblings than younger siblings. Even applying these criteria, our sample selections included more female pairs than male pairs and more older than younger singleton siblings.

1.2 NTR Survey 8

As part of a longitudinal survey study, this survey was sent out to adult twins registered with the NTR. It was completed by 10,176 multiples and 2,142 siblings and collected information on a wide range of traits [120]. After applying the selection criteria, the sample for the present analyses consisted of 685 twin-sibling pairs, 177 (26%) being male. Average age (sd) of the twins at the time of survey completion was 30.4 (12.9) and of the siblings 32.1 (12.2) years. In 142 (21%) of the pairs, the twin was older than the sibling. We compared the twins and their singleton siblings on the following continuous traits: self-reported height and body mass index (BMI, calculated as weight(kg)/height2(m)); the big five personality dimensions (openness, conscientiousness, extraversion, agreeableness, neuroticism) as measured with the NEO Five-Factor Inventory [117, 121]; borderline personality components measured with the Personality Assessment Inventory-Borderline Features scale (PAI-BOR; [124]); sensation seeking score and its subscales thrill and adventure seeking, boredom susceptibility, disinhibition and experience seeking as measured with the Sensation Seeking Scale [119, 126]; attention deficit hyperactivity disorder (ADHD) as measured with the Conners’ Adult ADHD Rating Scales (CAARS; [116]); the anxious depression scale of the Adult Self-Report which combines elements of depression and anxiety [114]; dimensions of social support (confidant and affective) as measured with the Duke-UNC Functional Social Support Questionnaire; and life satisfaction as measured with the Satisfaction With Life Scale [118]; loneliness as measured with the Three-Item Loneliness Scale [122]. In addition, we compared twins and siblings on categorical traits with outcomes operationalized as yes versus no, including the following traits: being in good health (reports of good or excellent health were coded as yes), ever been in contact with mental health services, being a current smoker, drinking alcohol regularly (reports of drinking alcohol 2 or more times per week were classified as yes), ever tried hash, being in a relationship (data only included for those age 30 years and older), and living together with a partner (data only included for those aged 30 years and older).

1.3 NTR Biobank

Between 2004 and 2010, 9530 individuals provided a blood sample and health-related information as part of a large-scale biobank project [125]. When conducting the selection procedure as described above, this resulted in 382 twin-sibling pairs, of which 144 (38%) were male-male pairs. The average age of the twins was 36.3 (12.3) and of the siblings 37.4 (12.0). In 265 pairs, the singleton sibling was older than the twin. We compared twins and their singleton siblings on the following variables: lipid profile (total cholesterol, HDL, LDL, and triglyceride levels), glucose metabolism (glucose, insulin, and HbA1c levels), white and red blood cell counts, C-reactive protein as indicator of general inflammation, liver enzymes alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyltransferase (GGT), creatinine as measure of kidney function and telomere length. For lipid profile and glucose metabolism, data were only included if the participant had kept to the instruction to be fasting at the time of blood collection (see [125]).

1.4 Analyses

All analyses were conducted in IBM SPSS Statistics version 25. To compare the twins with their singleton sibling, we conducted a paired-sample t-test for continuous traits and a McNemar chi-squared test for categorical traits. As age and BMI may be important factors in the physiological parameters, we here correlated the differences in age and BMI for the twins and siblings with their differences in physiological parameters and present the test outcomes for age, sex, and BMI standardized residuals. Considering the large number of comparisons conducted, we consider a trend when p-values are between 0.010 and 0.001 and p-values <0.001 as significant.

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Willemsen, G., Odintsova, V., de Geus, E., Boomsma, D.I. (2021). Twin-Singleton Comparisons Across Multiple Domains of Life. In: Khalil, A., Lewi, L., Lopriore, E. (eds) Twin and Higher-order Pregnancies. Springer, Cham. https://doi.org/10.1007/978-3-030-47652-6_4

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