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  • Title: Twin pregnancies in Cardiff and Vale of Glamorgan over four decades: natural twinning is on the increase.
    Author: Faisel H, Majoko F, Shebl F, Lindsay P.
    Journal: Eur J Obstet Gynecol Reprod Biol; 2008 Aug; 139(2):164-8. PubMed ID: 18384928.
    Abstract:
    OBJECTIVE: To assess trends in twinning over four decades using a population-based registry. DESIGN: Ecological study to conduct trend analysis of twin pregnancies in a geographically defined area over 40 years. SETTING: All pregnancies in the Cardiff and Vale of Glamorgan area of South Wales from 1965 to 2004, as recorded in the Cardiff Birth Survey (CBS) database. METHODS: Trends of the incidence of all twin pregnancies (> or = 18 weeks of gestation) were calculated in 5-year increments, beginning with 1965-1969 and ending in 2000-2004. Natural twinning rates could only be calculated for the terminal five time periods (i.e., 1980-1984, 1985-1989, 1990-1994, 1995-1999, and 2000-2004), when information regarding non-spontaneous (iatrogenic) twinning was first collected in the database. All results were adjusted for maternal age. RESULTS: The total twinning rate was 13.1 per 1000 pregnancies in the 1st time period (1965-1969). Subsequently, there was a gradual reduction in twinning, reaching a nadir of 10.3 per 1000 for the time period 1980-1985 (Z=3.15, P value<0.001). This was followed by a gradual increase in twinning, reaching a maximum of 15.7 per 1000 for both 1995-1999 and 2000-2004 (Z=-5.18, P value<0.0001). After exclusion of the cases of iatrogenic pregnancies, the natural twinning rate showed a continuous and gradual increase from 10 per 1000 spontaneous pregnancies in 1980-1984 to 13.3 per 1000 in 2000-2004 (Z=-5.08, P value<0.0001). CONCLUSION: The data showed a gradual, continuous increase in natural twinning rates over the last two decades. Such an increase cannot be attributed to the rise in maternal age alone.
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