Why is it in the News?
- A recent demographic study highlights India will continue to host the largest population of twins globally, despite declining twinning rates.
- Emphasises public health, maternal care, and demographic planning for higher-risk pregnancies.
- Highlights the need for a national twin registry to study genetics, environment, and disease susceptibility.
Relevance:
- GS 2 – Governance / Health Policy
- Maternal and child health planning, high-risk pregnancies, public health preparedness.
- Need for twin registries for better healthcare and demographic planning.
- GS 3 – Science & Technology
- Population studies, fertility patterns, assisted reproductive technologies (ART).
- Genetic vs. environmental factors in disease research.
Basic Concepts
- Twinning rate: Number of twin births per 1,000 deliveries.
- Importance:
- Medical: Twin pregnancies are higher-risk for both mother and babies.
- Demographic: Reflects fertility patterns, maternal age trends, and use of fertility treatments (e.g., IVF).
- Knowledge gap: Most studies focus on high-income countries; low-income countries like India are underrepresented.
Study Overview
- Conducted by Max Planck Institute for Demographic Research (Germany) and Swedish Collegium for Advanced Study.
- Data: Over 3 million births from 1980–2015 across 39 low-income countries.
- Method: Statistical modeling to assess effects of:
- Maternal age changes
- Population growth
- Fertility patterns
- Assisted reproductive technologies (ART)
Key Findings
- India’s twinning rate expected to fall by ~10.5% by 2100 due to:
- Declining overall fertility
- Fewer pregnancies per woman
- Despite decline: India remains world’s largest twin population due to its sheer population size (~23.4% share among studied countries).
- Urbanisation and pollution may influence twin studies’ relevance for diseases like asthma and COPD.
- Maternal age effect: Older maternal age increases twin likelihood.
- Impact of MAR/ART: IVF and fertility treatments may increase future twinning rates, which current projections may underestimate.
Public Health Implications
- Twins are higher-risk pregnancies: more frequent in later pregnancies, with early-pregnancy twins having higher mortality.
- Health system response:
- Train frontline health workers for twin care and monitoring.
- Targeted interventions to improve twin survival.
- Need for twin registries:
- Track genetics vs. environment in disease development.
- Inform prevention, diagnosis, and policy.
- Examples:
- Swedish registry: 30 ongoing projects on cancer, dementia, cardiovascular disease, hormone effects.
- Chinese registry: Focus on environmental exposures.
- Danish registry: Links cancer, blood cancer risk factors, and female hormones with cognition.
Significance
- Provides demographic and public health foresight in India.
- Guides maternal and child health policy, especially in low-income regions.
- Forms basis for establishing India’s national twin registry, aiding research in genetics, environment, and chronic diseases.
- Helps forecast healthcare needs and train personnel for high-risk twin pregnancies.
Quick Revision
- Definition: Twinning rate = twin births per 1,000 deliveries.
- India 2100 projection: 10.5% decline, but still largest twin population globally.
- Influencing factors: Maternal age, ART use, fertility patterns.
- Health priority: Train workers, monitor twins, improve survival rates.
- Research utility: Genes vs. environment in disease; policy planning.
