30 July 2022 – 13:13
A baby that receives fewer nutrients in the womb than his or her identical twin brother or sister has more developmental problems later in life. That is what researchers from the Leiden University Medical Center (LUMC) write in The Lancet Child & Adolescent Health. Their study shows that adverse conditions in the womb can lead to lifelong adverse health effects.
The researchers looked specifically at genetically identical, or identical, twins where the shared placenta was unevenly distributed during pregnancy. This occurs in 10 to 15% of these twin pregnancies. “You can compare it with one child experiencing the Hunger Winter while the other is in the Bahamas”, explains Jeanine van Klink, child psychologist and researcher at the Willem-Alexander Children’s Hospital (WAKZ). As a result, one child is sometimes twice to three times as large at birth as the identical twin brother or sister.
Suspicion confirmed
The research team has now shown that if a baby falls behind in growth during pregnancy, this has adverse effects later in life. “We invited 48 twin pairs between the ages of 4 and 17 with a growth difference for this so-called LEMON study,” says PhD student Sophie Groene. All these twins were born in the LUMC. The WAKZ is the national referral center and top referral treatment center for identical twin pregnancies in which the twins share one placenta. The Heart Foundation sponsors the LEMON study.
Groene: “We have taken an IQ test and a motor test on all children. We see that the children who are smaller at birth, on average, score lower on all domains of intelligence compared to their twin brother or sister and that they are more likely to have a (mild) psychomotor developmental delay.” These results confirm what was often already believed by the parents and the researchers. “I’ve been working with this group of twins for about 10 years and always suspected that the smaller of the two developed differently in many cases. Now we have the first scientific proof that this is indeed the case,” says Van Klink.
Twins keep following
According to Van Klink and Groene, this study shows that the care and attention for these twins should not stop as soon as they leave the hospital. “It is important to continue to monitor these children. Only then can we detect development problems early and offer support if necessary,” says Van Klink. “In addition, we can now provide the parents of these twins with better information,” Groene adds. The LEMON study is also investigating whether the difference in growth before birth has an effect on the development of the heart and lungs. “We also measured the growth of these twins and we use the growth curves of the health clinic to study the growth patterns in the first years of life,” says Groene. The results of these studies are expected shortly.
Long-term health
The researchers emphasize that they could not conduct this study without the commitment and involvement of the twins and their parents. “Parents share their experiences, the differences they see within the twins, but also their concerns with us. This is extremely valuable, because after all, they know their children best,” says Van Klink. “With their help, we gain more insight into the long-term health of these special twins and we can improve the care for them a bit better,” Groene concludes.
Source: LUMC
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Editorial Medicalfacts/ Janine Budding
I studied physiotherapy and health care business administration. In addition, I am a registered Independent client supporter and informal care broker. I have a lot of experience in various positions in healthcare, the social domain and the medical, pharmaceutical industry, nationally and internationally. And have broad medical knowledge of most specialties in healthcare. And of the health care laws from which health care is regulated and financed. Every year I attend most of the leading medical conferences in Europe and America to keep my knowledge up-to-date and to keep up with the latest developments and innovations. I am currently doing a Masters in Applied Psychology.
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