Congenital heart defects in a large, unselected cohort of monochorionic twins

• Published in: Journal of perinatology Vol. 33; no. 6; pp. 457 - 461
• Main Authors: Pettit, K E, Merchant, M, Machin, G A, Tacy, T A, Norton, M E
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-06-2013; Nature Publishing Group
• Subjects: 692/699/75/1539; 692/700/1720; 692/700/478/174; California; Care and treatment; Cohort analysis; Cohort Studies; Congenital heart disease; Cross-Sectional Studies; Defects; Diagnosis; Diseases in Twins - diagnostic imaging; Diseases in Twins - epidemiology; Diseases in Twins - genetics; Echocardiography; Embryos; Female; Fetofetal Transfusion - epidemiology; Fetuses; Follow-Up Studies; Gynecology; Health aspects; Heart; Heart Defects, Congenital - diagnostic imaging; Heart Defects, Congenital - epidemiology; Heart Defects, Congenital - genetics; Heart Septal Defects - diagnostic imaging; Heart Septal Defects - epidemiology; Heart Septal Defects - genetics; Humans; Incidence; Infant; Infant, Newborn; Infants; Male; Medical records; Medicine; Medicine & Public Health; Obstetrics; original-article; Pathology; Pediatric Surgery; Pediatrics; Pregnancy; Reproductive health; Retrospective Studies; Risk analysis; Risk factors; Transfusion; Twins; Twins, Monozygotic; Ultrasonic imaging; United States; Northern California; San Francisco California; California; United States > US; multiple gestations; twin-to-twin transfusion syndrome; anomalies; monochorionic twins; congenital heart defect; cardiac
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2012.145

Objective:
To determine the prevalence of congenital heart defects (CHDs) in a large, unselected cohort of monochorionic (MC) twins.
Study Design:
We completed a chart review of all MC twin pregnancies in the Kaiser Permanente Northern California population from 1996 to 2003. CHDs were identified by diagnostic codes and confirmed by postnatal echocardiograms. Follow-up was obtained through one year of age.
Result:
A total of 926 liveborn MC twins met inclusion criteria. The prevalence of CHDs was 7.5%, 11.6 times the general population rate (CI 9.2 to 14.5). Septal defects were most common. 20% of infants with heart defects had twin-to-twin transfusion syndrome (TTTS) versus 8% of infants without defects (
P
<0.01); this association remained significant when controlling for potential confounders.
Conclusion:
The prevalence of CHDs in this large cohort of MC twins was significantly higher than the general population rate, with TTTS an added risk factor.