{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T12:32:54Z","timestamp":1769517174377,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,8,2]],"date-time":"2013-08-02T00:00:00Z","timestamp":1375401600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Twinning is a risk factor for birth defects. Using population\u2010based data from the Utah Birth Defect Network and the Utah Department of Health Vital Records, we investigated whether twinning increases the risk of major structural birth defects in live\u2010born opposite\u2010sex (OS) and same\u2010sex (SS) twins as proxies for monozygotic and dizygotic twins, respectively. We also assessed whether maternal age modified the association between twinning and birth defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>All resident live\u2010born singleton (n\u2009=\u2009492,143) and twin (n\u2009=\u200913,596) infants issued a Utah birth certificate and delivered from 1999 through 2008 were included. Unadjusted and adjusted odds ratios (aORs) with 95% confidence intervals were calculated for each birth defect using unconditional logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Birth defects were slightly more likely to occur in SS (aOR\u2009=\u20091.94; 95% confidence interval, 1.70\u20132.21) than OS (aOR\u2009=\u20091.55; 95% confidence interval, 1.27\u20131.90) twins. The aORs stratified by maternal age did not show a trend for any twin type when calculated for all birth defects combined. However, trends were observed for coarctation, pyloric stenosis, and shaft or penoscrotal hypospadias in OS twins; microcephaly, anotia\/microtia, conotruncal defects, membranous ventricular septal defects, pyloric stenosis, all hypospadias, and craniosynostosis in SS twins; and tetralogy of Fallot, right ventricular outflow tract obstructions, renal agenesis\/hypoplasia, and craniosynostosis in all twins.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>All twin types have an increased risk for birth defects compared with singletons. SS twins have the highest risk, presumably due to the influence of monozygotic twins. The risk for birth defects in twins was not significantly modified by the mother's age. <jats:italic>Birth Defects Research (Part A) 97:554\u2010563, 2013<\/jats:italic>. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdra.23156","type":"journal-article","created":{"date-parts":[[2013,8,2]],"date-time":"2013-08-02T15:26:59Z","timestamp":1375457219000},"page":"554-563","source":"Crossref","is-referenced-by-count":26,"title":["Association of twinning and maternal age with major structural birth defects in Utah, 1999 to 2008"],"prefix":"10.1002","volume":"97","author":[{"given":"Renee A.","family":"Rider","sequence":"first","affiliation":[{"name":"Genomic Medicine Service, Department of Veterans Affairs Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics, Department of Pediatrics, University of Utah Health Sciences Center Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice E.","family":"Rinsky","sequence":"additional","affiliation":[{"name":"Maternal Fetal Diagnostic Center, University of Utah Health Sciences Center Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia L.","family":"Feldkamp","sequence":"additional","affiliation":[{"name":"Division of Medical Genetics, Department of Pediatrics, University of Utah Health Sciences Center Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,8,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.161.4.334"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.6.1649"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.45.1.43"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20212"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/den104"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.32745"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1002\/0471722146","volume-title":"Applied logistic regression","author":"Hosmer DW","year":"2000"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1542\/peds.78.1.85","article-title":"Congenital microcephaly due to vascular disruption: in utero documentation","volume":"78","author":"Hughes HE","year":"1986","journal-title":"Pediatrics"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(94)00354-G"},{"key":"e_1_2_6_11_1","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1542\/peds.73.4.467","article-title":"Congenital hydranencephaly\/porencephaly due to vascular disruption in monozygotic twins","volume":"73","author":"Jung JH","year":"1984","journal-title":"Pediatrics"},{"key":"e_1_2_6_12_1","first-page":"69","article-title":"Congenital malformation in twins","volume":"32","author":"Layde PM","year":"1980","journal-title":"Am J Hum Genet"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.10093"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2009.02227.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2008.01.009"},{"key":"e_1_2_6_16_1","first-page":"1","article-title":"Births: final data for 2005","volume":"56","author":"Martin JA","year":"2007","journal-title":"Natl Vital Stat Rep"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8628(19990312)83:2<117::AID-AJMG7>3.0.CO;2-4"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1095\/biolreprod.112.103440"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2012.31.4.555"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1375\/twin.8.6.543"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/den387"},{"key":"e_1_2_6_22_1","unstructured":"Rural Health Research Center.2004. 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