{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:41:55Z","timestamp":1792136515812,"version":"4.4.0"},"reference-count":14,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2000,11,15]]},"published-print":{"date-parts":[[2001,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Monozygotic twins are at greater risk of dying and of serious morbidity than dizygotic twins, and both are at greater risk than singletons. This is only partly explained by the higher proportion of low birthweight infants among twins.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>AIM<\/jats:title>\n                  <jats:p>To compare, in same sex and different sex twins, birth weight specific neonatal death rates and cerebral palsy prevalence rates in the surviving twin when the co-twin has died in infancy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Analysis of birth and death registration data for same sex and different sex twins for England and Wales 1993\u20131995 where both were live births. Death certificates of all liveborn twins who died were obtained from the Office for National Statistics. A questionnaire was sent to the general practitioners of all surviving co-twins to determine if the child had any disability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The neonatal death rate in same sex twins was 25.4 and in different sex twins 18.0 per 1000 live births (death rate difference 7.4; 95% confidence interval 4.7 to 10.1; p\u2009&lt;\u20090.001). The higher neonatal death rate in same sex compared with different sex twins is attributable to the higher proportion of same sex twins with low birth weight. Prevalence of cerebral palsy in the low birthweight group (&lt;\u20091000 g) was marginally higher in same sex (224 per 1000) than different sex (200 per 1000) twin survivors. In the birth weight group 1000\u20131999 g, same sex twin survivors were at a significantly higher risk of cerebral palsy than those of different sex: 167 <jats:italic>v<\/jats:italic> 21 per 1000; difference 145 (95% confidence interval 44 to 231; p\u2009&lt;\u20090.01) per 1000 infant survivors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>There are two components to the cause of cerebral palsy in twins. Immaturity per se predisposes to cerebral damage. Also, same sex twins may sustain cerebral damage that is in excess of that due to immaturity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/fn.84.2.f111","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:40:22Z","timestamp":1027752022000},"page":"F111-F116","source":"Crossref","is-referenced-by-count":35,"title":["Cerebral palsy in the surviving twin associated with infant death of the co-twin"],"prefix":"10.1136","volume":"84","author":[{"given":"P O D","family":"Pharoah","sequence":"first","affiliation":[{"name":"FSID Unit of Perinatal and Paediatric Epidemiology, Muspratt Building, Department of Public Health, University of Liverpool, Liverpool L69 3GB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2001,3,1]]},"reference":[{"key":"2025090511320312000_84.2.F111.1","first-page":"854","article-title":"Twinning and cerebral palsy in four northern Californian counties: births 1983 through 1985.","volume":"92","author":"Grether","year":"1993","journal-title":"Pediatrics"},{"key":"2025090511320312000_84.2.F111.2","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1136\/bmj.307.6914.1239","article-title":"Twins, triplets and cerebral palsy births in Western Australia in the 1980s.","volume":"307","author":"Petterson","year":"1993","journal-title":"BMJ"},{"key":"2025090511320312000_84.2.F111.3","doi-asserted-by":"crossref","first-page":"F174","DOI":"10.1136\/fn.75.3.F174","article-title":"Cerebral palsy and multiple births.","volume":"75","author":"Pharoah","year":"1996","journal-title":"Arch Dis Child"},{"key":"2025090511320312000_84.2.F111.4","first-page":"142","article-title":"Prognosis and long-term follow-up of a twin after antenatal death of a co-twin.","volume":"38","author":"Rydhstr\u00f6m","year":"1993","journal-title":"J Reprod Med"},{"key":"2025090511320312000_84.2.F111.5","first-page":"141","article-title":"Twin pregnancies complicated by the death of one fetus in the second or third trimester.","volume":"4","author":"Ishimatsu","year":"1994","journal-title":"Journal of Maternal and Fetal Investigation"},{"key":"2025090511320312000_84.2.F111.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02215-7"},{"key":"2025090511320312000_84.2.F111.7","first-page":"346","article-title":"Beitr\u00e4ge zur physiologie und pathologie der mehrlingsgeburten beim menshem.","volume":"88","author":"Weinberg","year":"1902","journal-title":"Archiv f\u00fcr die gesamte Physiologie des Menschen und der Tiere"},{"key":"2025090511320312000_84.2.F111.8","doi-asserted-by":"publisher","DOI":"10.2307\/3001775"},{"key":"2025090511320312000_84.2.F111.9","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1111\/j.1469-8749.1985.tb03805.x","article-title":"Development of cerebral palsy after ultrasonographic detection of periventricular cysts in the newborn.","volume":"27","author":"Weindling","year":"1985","journal-title":"Dev Med Child Neurol"},{"key":"2025090511320312000_84.2.F111.10","doi-asserted-by":"publisher","DOI":"10.1136\/adc.60.4.349"},{"key":"2025090511320312000_84.2.F111.11","first-page":"399","article-title":"Neonatal periventricular leukomalacia: diagnosis and evolution evaluated by real-time ultrasound.","volume":"41","author":"Tamisari","year":"1986","journal-title":"Helvetica Paedriatrica Acta"},{"key":"2025090511320312000_84.2.F111.12","doi-asserted-by":"publisher","DOI":"10.1136\/adc.65.5.469"},{"key":"2025090511320312000_84.2.F111.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1997.tb10948.x"},{"key":"2025090511320312000_84.2.F111.14","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0404.2000.00308.x"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fn.84.2.F111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T18:53:38Z","timestamp":1757098418000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fn.84.2.F111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,3,1]]},"references-count":14,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2001,3,1]]},"published-print":{"date-parts":[[2001,3,1]]}},"alternative-id":["10.1136\/fn.84.2.F111"],"URL":"https:\/\/doi.org\/10.1136\/fn.84.2.f111","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"value":"1359-2998","type":"print"},{"value":"1468-2052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,3,1]]}}}