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Human Genetics Society of Australasia Position Statement: Online or Direct-to-Consumer Genomics Testing. 澳大利亚人类遗传学会立场声明:在线或直接面向消费者的基因组学测试。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-12-22 DOI: 10.1017/thg.2025.10033
Julia Mansour, Rebekah McWhirter, Alison McLean, Alison McIvor, Natasha Heather

This position statement provides guidelines for health professionals who are considering online or direct-to-consumer genetic testing for their patients. It presents the major issues around online and direct-to-consumer (DTC) testing including how it is accessed, motivations for accessing testing and how to return these results. Online or DTC recommendations include: (1) DTC testing should only be done by individuals/consumers who are well informed, aware of the risks, benefits and limitations of testing, and able to consent for their DNA to be collected, analyzed and potentially stored. Where possible, individuals/consumers should also be aware of the alternative option of undertaking testing through healthcare professionals in a clinical context, and the benefits of this. (2) Decisions about having a child tested should be based on peer-reviewed, published evidence. Genomics testing for children should be within a clinical context where parents are informed, have access to clinical support and professional genetic counseling about this decision, as well as support for the range of results received. (3) Parents considering direct-to-consumer testing on their newborn are counselled, or given information, to encourage them to have standard government funded newborn bloodspot screening testing on their newborn. (4) When choosing an online genomic test, preference should be given to tests undertaken in accredited laboratories offering tests accredited with the Therapeutic Goods Administration. (5) Results obtained through methods other than direct analysis from a laboratory accredited to perform genomic testing to inform human health and wellbeing should be interpreted with caution. The HGSA recommends that such results must be confirmed in an accredited diagnostic laboratory prior to relying on them to inform options for treatment, surveillance or risk reduction, or before undertaking cascade testing in family members. (6) When individuals are concerned about their health, they should consult an appropriate healthcare professional to decide whether an online genomic test is appropriate and discuss how useful test results could be to make health-related decisions.

本立场声明为正在考虑为其患者进行在线或直接面向消费者的基因检测的卫生专业人员提供指导。它提出了在线和直接面向消费者(DTC)测试的主要问题,包括如何访问,访问测试的动机以及如何返回这些结果。在线或DTC的建议包括:(1)DTC测试应该只由知情的个人/消费者进行,他们知道测试的风险、好处和局限性,并且能够同意收集、分析和可能存储他们的DNA。在可能的情况下,个人/消费者也应该了解在临床环境中通过医疗保健专业人员进行测试的替代选择,以及这样做的好处。(2)对孩子进行检测的决定应该基于同行评审的、已发表的证据。儿童基因组学检测应该在临床环境中进行,父母应该被告知,可以获得临床支持和关于这一决定的专业遗传咨询,以及对所收到的结果范围的支持。(3)向考虑对新生儿进行直接面向消费者检测的父母提供咨询或信息,鼓励他们对新生儿进行标准的政府资助的新生儿血斑筛查检测。(4)在选择在线基因组检测时,应优先考虑在提供经美国药品管理局认可的检测的认可实验室进行的检测。(5)应谨慎解释通过非直接分析方法获得的结果,这些结果来自经认可进行基因组测试以告知人类健康和福祉的实验室。HGSA建议,这些结果必须在经认可的诊断实验室进行确认,然后才能根据这些结果确定治疗、监测或降低风险的方案,或者在家庭成员中进行级联检测之前。(6)当个人担心自己的健康时,他们应该咨询适当的医疗保健专业人员,以决定在线基因组测试是否合适,并讨论测试结果对做出与健康有关的决定有多大用处。
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引用次数: 0
The Interplay of Genes and Environment Across Multiple Studies (IGEMS) Consortium After Fifteen Years. 基因与环境的相互作用跨越多个研究(IGEMS)联盟十五年。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-12-19 DOI: 10.1017/thg.2025.10036
Deborah Finkel, Brian K Finch, Margaret Gatz, Kaare Christensen, Carol E Franz, Ida K Karlsson, William S Kremen, Robert F Krueger, Michelle Lupton, Nicholas Martin, Matt McGue, Miriam A Mosing, Jenae Neiderhiser, Marianne Nygaard, Elizabeth Prom-Worley, Chandra Reynolds, Perminder Sachdev, Elina Sillanpää, Eero Vuoksimaa, Keith E Whitfield, Orla Hayden, Ellen Walters, Nancy L Pedersen

The Interplay of Genes and Environment across Multiple Studies (IGEMS) is a consortium of 21 twin studies from 5 countries (Australia, Denmark, Finland, Sweden, and United States) established to explore the nature of gene-environment interplay in cognitive, physical, and emotional health across the adult lifespan. The combined data from over 145,000 participants (aged 18 to 108 years at intake) has supported multiple research projects over the three phases of development since its inception in 2010. Phases 1 and 2 focused on launching and growing the consortium and supported important developments in data harmonization, analyses of data pooled across multiple studies, incorporation of linkages to national registries and conscription data, and integration of molecular genetic and classical twin designs. IGEMS Phase 3 focuses on developing appropriate infrastructure to maximize utilization of this large twin consortium for aging research.

跨多个研究的基因与环境相互作用(IGEMS)是一个由来自5个国家(澳大利亚、丹麦、芬兰、瑞典和美国)的21个双胞胎研究组成的联盟,旨在探索在整个成人生命周期中,基因与环境在认知、身体和情感健康方面相互作用的本质。自2010年启动以来,来自145,000多名参与者(年龄在18岁至108岁之间)的综合数据支持了三个发展阶段的多个研究项目。第一阶段和第二阶段的重点是启动和发展联盟,并支持数据协调方面的重要发展,分析跨多个研究汇集的数据,纳入与国家登记和征兵数据的联系,以及整合分子遗传学和经典双胞胎设计。IGEMS第三阶段的重点是开发适当的基础设施,以最大限度地利用这个大型双胞胎联盟进行老龄化研究。
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引用次数: 0
Turner's Syndrome in Discordant Dizygotic Twins: Biological Origins and Twin Relations/Twin Research Reviews: Prevention of Premature Twin Birth; Twin Gestation with Hydatidiform Mole; Update on Feingold Syndrome Twins; Qualitative MZ Twin Difference Studies/Media: Identical Twins Turn 100 Years of Age; Twins in Famous Families; Celebration of Yorùbá Twins of Nigeria; Identical Artistic Partners; Rare Conjoined Twins Separated. 异卵双胞胎的特纳综合征:生物学起源和双胞胎关系/双胞胎研究综述:双胞胎早产的预防双胎妊娠伴葡萄胎;法因戈尔德综合征双胞胎最新进展;定性MZ双胞胎差异研究/媒介:同卵双胞胎100岁名人家庭中的双胞胎;尼日利亚双胞胎Yorùbá庆祝活动;相同的艺术伙伴;罕见连体双胞胎分离。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-12-04 DOI: 10.1017/thg.2025.10034
Nancy L Segal

A pair of dizygotic (DZ) twins discordant for Turner syndrome are discussed with reference to the biological origins of the condition and the effects of discordance on the twin relationship. There is little research on how having an atypical twin influences the life events and goals of the typical twin. Next, timely reviews of research on preventing premature twin birth, a twin gestation with hydatidiform mole, an update on Feingold syndrome twins discussed in a previous issue of this journal, and qualitative monozygotic twin difference studies are presented. The final portion of this article covers human interest stories of twins that are variously entertaining and enlightening. They include identical twins who celebrated their 100th birthday together, twins in famous families, celebration of the Yorùbá twins of Nigeria, identical artistic partners, and surgical separation of a rare, conjoined twin set.

本文讨论了一对异卵(DZ)双胞胎的特纳综合征,参考条件的生物学起源和不一致对双胞胎关系的影响。关于非典型双胞胎如何影响典型双胞胎的生活事件和目标的研究很少。接下来,及时回顾了预防双胞胎早产的研究,双胎妊娠合并葡萄胎,本刊上一期讨论的法因戈尔德综合征双胞胎的最新进展,以及定性的同卵双胞胎差异研究。本文的最后一部分涵盖了双胞胎的人类兴趣故事,这些故事具有各种娱乐性和启发性。其中包括一起庆祝100岁生日的同卵双胞胎,名人家庭的双胞胎,尼日利亚Yorùbá双胞胎庆典,同卵艺术伙伴,以及罕见的连体双胞胎手术分离。
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引用次数: 0
Genetics, Diet or Divine Blessing? Local and Scientific Explanations for High Dizygotic Twinning in Igbo-Ora, Nigeria. 基因、饮食还是神的恩赐?尼日利亚伊博奥拉地区高异卵双胞胎的地方和科学解释。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-11-27 DOI: 10.1017/thg.2025.10029
Akinwale Fadoju

Igbo-Ora, a town in southwestern Nigeria, is renowned for exceptionally high dizygotic twin birth rates, recording approximately 45 per 1000 live births. This article explores the factors behind this unique phenomenon by critiquing the community's perceptions and narrative of the factors responsible for the high twinning rate and comparing these perceptions with biomedical hypotheses. Drawing on 6 months of ethnographic fieldwork - participant observation, 81 semistructured interviews, and FGDs - this study documents local narratives that highlight hereditary 'twin threads' -; specific foods, notably Ilasa (okra-leaf soup) and cassava meals; environmental qualities of 'air' and 'water'; and divine sanction as factors responsible for the incidence of twin birth in Igbo-Ora. These local narratives are analyzed against certain biomedical perspectives on maternal age and parity effects, putative genetic variants influencing gonadotrophins, and dietary phytoestrogens. The study found that the community resist single-cause explanations for the incidence of twin birth and instead articulates a complementarity of genetic, ecological, dietary, and spiritual factors. This holistic framing contrasts with and complements prevailing genetic and nutritional theories surrounding the incidence of twin birth. The article argues that future genetic and epidemiological investigations in high-twinning populations must be culturally attuned to ensure accurate phenotype definition, ethical engagement, and translational relevance.

伊博奥拉是尼日利亚西南部的一个小镇,以异常高的异卵双胞胎出生率而闻名,每1000名活产婴儿中约有45名。本文通过批评社会对高双胞胎率的因素的看法和叙述,并将这些看法与生物医学假设进行比较,探讨了这一独特现象背后的因素。通过6个月的民族志田野调查——参与者观察、81次半结构化访谈和fgd——本研究记录了突出遗传“双线”的地方叙事。特定的食物,特别是Ilasa(秋葵叶汤)和木薯餐;“空气”和“水”的环境品质;以及神圣的认可是导致伊博-奥拉族双胞胎发生率的因素。这些地方叙事分析了某些生物医学观点对产妇年龄和胎次的影响,假设的遗传变异影响促性腺激素和膳食植物雌激素。研究发现,该群体反对对双胞胎发生率的单一原因解释,而是阐明了遗传、生态、饮食和精神因素的互补。这种整体框架与围绕双胞胎出生发生率的流行遗传和营养理论形成对比并加以补充。文章认为,未来在高双胞胎人群中的遗传和流行病学调查必须与文化相适应,以确保准确的表型定义、伦理参与和翻译相关性。
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引用次数: 0
The Overlooked Legacy: Genetic Contributions of the Childless - ERRATUM. 被忽视的遗产:无子女的遗传贡献-勘误。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-11-10 DOI: 10.1017/thg.2025.10023
Vegard F Skirbekk, Bernt Bratsberg, Christian M Page, Dana Kristjansson
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引用次数: 0
An Exploration of the Genetic Architecture of Pregnancy-Related Linea Nigra and Its Relationship With Pigmentation Phenotypes. 妊娠相关黑线遗传结构及其与色素沉着表型关系的探讨。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-11-04 DOI: 10.1017/thg.2025.10026
Svetlana Bivol, Mathias Seviiri, Lucía Colodro-Conde, Brittany L Mitchell, Catherine M Olsen, David C Whiteman, Matthew H Law, Penelope A Lind, Jodie N Painter, Sarah E Medland

Human eye, skin and hair color pigmentation are highly heritable traits influenced by hundreds of genetic loci. The heritability and genetic etiology of the hyperpigmentation trait pregnancy-related linea nigra (PLN), where a dark but usually temporary vertical line develops on the abdomen, is unknown, and our understanding of its relationships with other pigmentation traits is limited. We conducted a genetic study of self-reported PLN in women of European ancestry, using a genome-based restricted maximum likelihood (GREML) method to estimate PLN heritability, performing a genomewide association study (GWAS) to explore the genetic factors underlying PLN, and calculating polygenic risk scores (PRS) to assess whether this trait shares genetic liability with two other skin pigmentation phenotypes, skin colour and mole count. We found 35% of the variance in developing PLN was explained by common genetic variation. The GWAS revealed four genomic loci suggestively associated (p values ≤ 1 × 10-6) with PLN: rs1263154 near the UPP2 gene (p = 9.0 × 10-7), rs26331 near SEMA6A (p = 6.6 × 10-7), rs78371540 in OLFM3 (p = 5.5 × 10-7), and rs72693263 near FLRT2 (p = 1.1 × 10-7). Of these genes only OLFM3 has been previously associated with pigmentation. Our PRS results provide the first evidence that genetic factors underlying skin color and mole count also contribute to the development of PLN in women of European ancestry.

人类的眼睛、皮肤和头发色素沉着是高度可遗传的性状,受数百个遗传位点的影响。妊娠相关黑线(PLN)是指腹部出现一条黑色但通常是暂时的竖线,其遗传性和遗传病因尚不清楚,我们对其与其他色素沉着特征的关系的了解也很有限。我们对欧洲血统女性自我报告的PLN进行了一项遗传研究,使用基于基因组的限制最大似然(GREML)方法来估计PLN的遗传力,进行全基因组关联研究(GWAS)来探索PLN的遗传因素,并计算多基因风险评分(PRS)来评估该性状是否与其他两种皮肤色素沉着表型,肤色和痣计数具有遗传倾损性。我们发现发生PLN的35%的变异可以用共同的遗传变异来解释。GWAS发现了4个与PLN呈显著相关(p值≤1 × 10-6)的基因组位点:UPP2基因附近的rs1263154 (p = 9.0 × 10-7), SEMA6A基因附近的rs26331 (p = 6.6 × 10-7), OLFM3基因附近的rs78371540 (p = 5.5 × 10-7), FLRT2基因附近的rs72693263 (p = 1.1 × 10-7)。在这些基因中,只有OLFM3先前与色素沉着有关。我们的PRS研究结果提供了第一个证据,表明肤色和痣数量背后的遗传因素也有助于欧洲血统女性PLN的发展。
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引用次数: 0
Heritability Estimates from Twin Studies: The Efficiency of the MZA Design. 双胞胎研究的遗传力估计:MZA设计的效率。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-10-24 DOI: 10.1017/thg.2025.10022
David T Lykken, Seymour Geisser, Auke Tellegen

The most accurate confidence intervals for estimates of heritability are based on Fisher's Z-transformation. Using these methods, Loehlin and Nichol's (1976) analysis is confirmed, viz., that it is pointless to estimate heritabilities from the classical twin method unless one is prepared to recruit upwards of 800 twin pairs for study. Even then the assumptions of that method are so improbable as to leave reasonable doubt about the true value of H. Estimates of H from the correlation of monozygotic twins reared apart (MZA twins), on the other hand, is remarkably more stable than that obtained by comparing MZ with DZ correlations. Moreover, estimates of H based on the MZA design rest upon more reasonable (and often testable) assumptions.

估计遗传率最准确的置信区间是基于费雪的z变换。使用这些方法,Loehlin和Nichol(1976)的分析得到了证实,即,除非准备招募800对以上的双胞胎进行研究,否则用经典的双胞胎方法来估计遗传能力是毫无意义的。即使这样,该方法的假设也是如此不可能,以至于对H的真实值留下了合理的怀疑。另一方面,从分开抚养的同卵双胞胎(MZA双胞胎)的相关性中估计的H比通过比较MZ和DZ相关性获得的H要稳定得多。此外,基于MZA设计的H估计依赖于更合理的(通常是可测试的)假设。
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引用次数: 0
Genetic Contributions to BMI Fluctuation and Its Associations With BMI and Its Trajectories Over Adolescence and Early Adulthood: A 25-Year Follow-Up Longitudinal Study of Finnish Twins. 遗传因素对BMI波动的影响及其与青春期和成年早期BMI及其轨迹的关联:芬兰双胞胎25年随访纵向研究
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-10-20 DOI: 10.1017/thg.2025.10030
Alvaro Obeso, Aline Jelenkovic, Jose Angel Peña, Gabin Drouard, Sari Aaltonen, Jaakko Kaprio, Karri Silventoinen

We examined how BMI, BMI trajectories, and BMI fluctuation around these trajectories in adolescence were correlated with BMI trajectories and BMI fluctuation in early adulthood, as well as the genetic basis of these associations. BMI data from Finnish twins (N = 1379, 48% males) were collected at ages 11.5, 14, 17.5, 24, and 37 years. BMI trajectories in adolescence (11.5-17.5 years) and early adulthood (17.5-37 years) were estimated using linear mixed-effect models. BMI fluctuation was calculated as the average squared differences between observed and expected BMI around these trajectories. Genetic twin models and a polygenic risk score for BMI (PRSBMI) were used to assess genetic contributions to BMI fluctuation and its associations with BMI and BMI trajectories. Adolescent BMI fluctuation was positively correlated with early adulthood BMI trajectories in females, while in males, adolescent BMI trajectories were positively associated with BMI fluctuation in early adulthood. Genetic factors affected BMI fluctuation in both adolescence and early adulthood when estimated using twin modelling and PRSBMI. Adolescent BMI was positively associated with early adulthood fluctuation in both sexes, with genetic factors playing a role (genetic correlations .08-.29). It was concluded that genetic factors play a significant role in BMI fluctuations in adolescence and early adulthood, with some overlap with the genetics of BMI.

我们研究了青春期的BMI、BMI轨迹和这些轨迹周围的BMI波动与成年早期的BMI轨迹和BMI波动之间的关系,以及这些关联的遗传基础。在11.5、14、17.5、24和37岁时收集芬兰双胞胎(N = 1379, 48%为男性)的BMI数据。使用线性混合效应模型估计青春期(11.5-17.5岁)和成年早期(17.5-37岁)的BMI轨迹。BMI波动是根据这些轨迹周围观察到的BMI和预期BMI之间的平均平方差来计算的。使用遗传双胞胎模型和BMI多基因风险评分(PRSBMI)来评估遗传对BMI波动的影响及其与BMI和BMI轨迹的关系。女性青少年BMI波动与成年早期BMI轨迹呈正相关,男性青少年BMI波动与成年早期BMI波动呈正相关。当使用双胞胎模型和PRSBMI估计时,遗传因素影响青春期和成年早期的BMI波动。青少年体重指数与两性成年早期波动呈正相关,遗传因素起作用(遗传相关性为0.08 - 0.29)。由此得出,遗传因素在青春期和成年早期BMI波动中起着重要作用,并与BMI遗传有一定的重叠。
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引用次数: 0
Behavioral Genetics and Human Agency: How Selectively Deterministic Theories of Free Will Drive Unwarranted Opposition to Behavioral Genetic Research and Undermine Our Moral and Legal Conventions, Part III. 行为遗传学和人类能动性:自由意志的选择性决定论如何推动对行为遗传学研究的无端反对,并破坏我们的道德和法律惯例,第三部分。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-10-18 DOI: 10.1017/thg.2025.10016
Damien Morris

This article argues that a pervasive but confused theory of free will is driving unwarranted resistance to behavioral genetic research and undermining the concept of personal responsibility enshrined in our moral and legal conventions. We call this the theory of 'free-will-by-subtraction'. A particularly explicit version of this theory has been propounded by the psychologist Eric Turkheimer, who has proposed that human agency can be scientifically quantified as the behavioral variation that remains unexplained after known genetic and environmental causes have been accounted for. This theory motivates resistance to research that suggests genetic differences substantially account for differences in human behavior because that is seen to reduce the scope of human freedom. In academic philosophy, free-will-by-subtraction theory corresponds to a position called 'libertarian incompatibilism', which holds that human beings are not responsible for behavior that has antecedent causes yet maintains that free will nonetheless exists because some fraction of human behavioral variation is self-caused. However, this position is rejected by most professional philosophers. We argue that libertarian incompatibilism is inconsistent with a secular materialist outlook in which all human behavior is understood to have antecedent causes whether those causes are known to science or not - an outlook Turkheimer shares. We show that Turkheimer sustains this contradiction by adopting an untenable position we call 'epistemic libertarianism', which holds that antecedent causes of our behavior only infringe on our freedom if we know about them. By contrast, the overwhelming majority of secular materialist philosophers support a position called 'compatibilism', which maintains that free will is compatible with the comprehensive causation of human behavior. We show that compatibilism neutralizes the threat that genetic explanation poses to human agency and rescues a generous conception of personal responsibility that aligns with our moral intuitions.

这篇文章认为,一种普遍但令人困惑的自由意志理论正在推动对行为基因研究的毫无根据的抵制,并破坏了我们的道德和法律惯例中所体现的个人责任概念。我们称之为“减法自由意志”理论。心理学家埃里克·图克海默(Eric Turkheimer)提出了这一理论的一个特别明确的版本,他提出,人类能动可以被科学地量化为在已知的遗传和环境原因被解释后仍然无法解释的行为变异。这一理论促使人们抵制那些认为基因差异在很大程度上解释了人类行为差异的研究,因为这被视为减少了人类自由的范围。在学院派哲学中,减法自由意志理论对应于一种被称为“自由意志不相容论”的立场,这种立场认为,人类不必为有先决原因的行为负责,但仍然认为自由意志是存在的,因为人类行为变化的某些部分是自我引起的。然而,这一立场被大多数专业哲学家所拒绝。我们认为,自由意志主义的不相容与世俗唯物主义的观点是不一致的,在世俗唯物主义的观点中,所有的人类行为都被理解为有预先的原因,无论这些原因是否为科学所知——这是图克海默所赞同的观点。我们表明,托克海默通过采取一种我们称之为“认知自由主义”的站不住脚的立场来维持这种矛盾,这种立场认为,我们行为的前因只有在我们知道它们的情况下才会侵犯我们的自由。相比之下,绝大多数世俗唯物主义哲学家支持一种称为“相容论”的立场,认为自由意志与人类行为的全面因果关系是相容的。我们的研究表明,相容主义消除了基因解释对人类能动性构成的威胁,并挽救了与我们的道德直觉一致的个人责任的慷慨概念。
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引用次数: 0
Trends and Factors Associated with Under-5 Excess Mortality among Twins in sub-Saharan Africa: A Study of 156 National Surveys from 42 Countries. 撒哈拉以南非洲地区5岁以下双胞胎超额死亡率的趋势和相关因素:对42个国家156项国家调查的研究。
IF 1.2 4区 医学 Q4 GENETICS & HEREDITY Pub Date : 2025-10-13 DOI: 10.1017/thg.2025.10007
Adama Ouedraogo, Sophie Le Coeur, Gilles Pison, Abdramane B Soura

Twin children are more likely to die than singletons. This is an additional burden in sub-Saharan African (SSA) countries, as child mortality levels are already higher than anywhere else. This article provides estimates of under-5 mortality rates (U5MRs) for twins and singletons in SSA from 1986 to 2016. It describes the geographical variations and changes over time. It also describes the variation of twins' excess mortality according to age from 0 to 5 years. Additionally, it analyzes the factors associated with twins' excess mortality. We used data from 156 national surveys from 42 countries. We estimated U5MRs for twins and single children and built a Cox model to analyze factors associated with excess mortality among twins. Although child mortality has declined on the continent, twins' excess mortality remains very high. U5MRs are, on average, 3 times higher among twins than singletons. The Cox model shows that all other things being equal, the adjusted hazard ratio of under-5 mortality (U5M) is 3.2 (2.9-3.3; p < .001) times higher among twins than singletons. The main factors associated with excess mortality risks among twins are biomedical and nutritional features, such as low birth weight, non-use of cesarean section delivery, and lack of breastfeeding. Health policy makers in SSA should be aware of the vulnerability of twins, and interventions to prevent their early deaths should be considered.

双胞胎比单胎更容易死亡。这在撒哈拉以南非洲国家是一个额外的负担,因为儿童死亡率已经高于其他任何地方。本文提供了1986年至2016年SSA双胞胎和单胎5岁以下儿童死亡率(U5MRs)的估计数。它描述了地理上的变化和随时间的变化。还描述了0 ~ 5岁年龄组双胞胎超额死亡率的变化情况。此外,它还分析了与双胞胎高死亡率相关的因素。我们使用了来自42个国家的156项全国性调查的数据。我们估计了双胞胎和单胎的u5mr,并建立了Cox模型来分析双胞胎中死亡率过高的相关因素。尽管非洲大陆的儿童死亡率有所下降,但双胞胎的超额死亡率仍然很高。平均而言,双胞胎的u5mr比单胎高3倍。Cox模型显示,在其他条件相同的情况下,双胞胎5岁以下儿童死亡率(U5M)的调整风险比是单胎的3.2倍(2.9-3.3;p < 0.001)。与双胞胎死亡风险过高相关的主要因素是生物医学和营养特征,如出生体重过低、未使用剖宫产以及缺乏母乳喂养。SSA的卫生决策者应意识到双胞胎的脆弱性,并应考虑采取干预措施防止其过早死亡。
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引用次数: 0
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Twin Research and Human Genetics
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