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标题： The Wuhan Twin Birth Cohort (WTBC): A Unique Resource for Clinical, Epidemiological and Genetic studies

讲者：张斌

单位：武汉市妇女儿童医疗保健中心

关键词：

Twin Birth Cohort Twin Birth Registry population-based biobank

播放： 2449

论文摘要： Purpose This cohort study came about to address the lack of knowledge with regard to the extent of genetic and environmental influences on multiple pregnancies and twins’ development in China. Our twin birth cohort aims to collect 25,000 twin pairs from pregnancy. Our goal is to obtain extensive data on health and lifestyle of both twins and their mothers. In addition, the WTBC also aims to study epigenetic markers and genes both in intrauterine and in childhood.
Method The Wuhan Pre/post-natal Twin Birth Registry (WPTBR) is the largest twin birth registry in China; it is also a population-based registry of twins residing in Wuhan City. It recruited women from the first trimester of pregnancy and their twins from birth. The WPTBR initiated the Wuhan Twin Birth Cohort (WTBC). The WTBC started in January 1, 2006, and it contains a complete coverage of all twin births (including still births); comprising a total of 13,869 twin pairs (27,553 individuals). Three different strategies were utilized for twin enrollments. First population strategy contains 6,920 twin pairs. This strategy links the twin cohort to the Wuhan Pre/post-natal Twin Birth Registry. Strategy two contains 6,949 twin pairs. This strategy contains pre/post-natal information from WPTBR but also neonatal blood spots from twins. The third strategy is a hospital-based approach. It is a prospective study that started on March 28, 2016 and will end in December 2020. This method consists of voluntary requests for enrolment of twins by their mothers at the Wuhan Medical & Healthcare Center for Women and Children. 1,000 pregnant women and their twin pairs is the target enrollment within the 5-year period. Information of mothers and twins will be registered in the WPTBR. We also established a biobank that is associated with the WPTBR; it includes prospective repeated biological samples (blood, cord blood, cord, urine, amniotic fluid, placenta, breast milk and meconium, etc.) till twins turn 18 years old.. The questionnaires includes baseline information, anxiety, depression during pregnancy, diet, psychological questions to assess behavior and cognitive functions of children 3 years or older, and health related environmental information of both mother and their twins. These information were not available in the original database. These questionnaires are completed using a specific website linked to the network tracking system developed for WTBC. Depending on the WPTBR, the participants in our study can be easily tracked. The tracking system has a track rate greater than 90%. The WTBC has an accurate classification on zygosity for all twin pairs in the third strategy and most of twin pairs in second strategy; which is not common in twin studies.
Results Fifty percent of the twins were born preterm and low-birth weight with ninety percent of the twins born by c-section. Lambda Mu Sigma (LMS) enabled a reference percentile curve to show 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentile birth weight by sex and gestational age from the 11,861 male and 10,646 female twins. The second strategy assessed 96.58% of the twins’ zygosity (6949).
Conclusions The Wuhan Twin Birth Cohort offers a unique opportunity to follow women from pre-natal to post-natal, as well as follow up of their twins. The follow-up method will allow researchers to trace the life history of mothers and twins; allowing disentanglement of genetic and environmental influences on health variations. The cohort study will expand the understanding of genetic and environmental influences on pregnancy and twin’s development in China. The study will help guide the care of pregnant women with twins and tract the development of their twins.