The Importance of a Twin Zygosity Test for Pregnant Women

 

By Angela Aina - CDC PHPS Fellow and First Time Attendee of the AMCHP Conference - January 2024

Pregnancy is an exciting and transformative time, especially for those expecting twins. One crucial piece of information that many expectant mothers may wonder about is whether their twins are identical or fraternal. This distinction is known as "zygosity." A twin zygosity test is a simple and informative way to determine whether your twins share the same genetic makeup. Understanding zygosity can provide valuable insights into pregnancy health, possible complications, and future medical care.

What is a Twin Zygosity Test?

A twin zygosity test analyzes the DNA of both twins to determine whether they are monozygotic (identical) or dizygotic (fraternal). Identical twins come from a single fertilized egg that splits into two embryos, while fraternal twins come from two separate eggs fertilized by two different sperm cells. The test typically involves a non-invasive DNA sample, usually obtained from a cheek swab, saliva, or blood test.

Why is it Important for Pregnant Women?

1. Understanding Pregnancy Risks and Complications
   Identifying whether your twins are identical or fraternal can help you better understand potential risks and complications. For example, identical twins may have a higher risk of certain pregnancy-related issues like twin-to-twin transfusion syndrome (TTTS) and monochorionic placentation, where the twins share the same placenta. Fraternal twins, on the other hand, are more likely to have separate placentas, which can reduce the likelihood of complications related to shared blood flow. A twin zygosity test allows doctors to monitor specific risks and tailor your prenatal care accordingly.

2. Genetic Insights for Future Health
   A zygosity test provides valuable genetic insights for your babies' future health. Since identical twins share the same DNA, they are more likely to inherit similar genetic traits, while fraternal twins might inherit different genetic characteristics. Understanding this can help in predicting potential hereditary conditions and allow for early interventions if necessary.

3. Bonding and Emotional Preparation
   Knowing whether your twins are identical or fraternal can also help you emotionally prepare for the journey ahead. Identical twins may share an incredibly close bond, which is fascinating for parents to witness, while fraternal twins might develop their own unique relationships. While both types of twins share a special connection, understanding the differences can help you prepare for their unique needs as they grow.

4. Family Planning and Medical History
   A twin zygosity test can offer valuable information if you're planning future pregnancies or managing family health history. Knowing whether your twins are identical or fraternal may provide important clues for determining the likelihood of having twins again and can be crucial for understanding your family's genetic makeup.

When to Consider a Twin Zygosity Test

• During Early Pregnancy: If you find out you’re expecting twins early on, the test can be performed to determine zygosity.

• If You're Curious About Your Twins’ Genetics: Some parents are simply curious about whether their twins are identical or fraternal, especially when early ultrasound results are unclear.

• If You Have a Family History of Twins: If twins run in your family, you might consider a zygosity test to understand your genetics and the possibility of having more twins in the future.

How the Test Works

The test is non-invasive and can usually be done with a simple saliva or cheek swab collection. The DNA samples from both twins are sent to a lab, where they are analyzed to determine whether the twins are identical (monozygotic) or fraternal (dizygotic). Results are typically available within a few weeks.

Conclusion

A twin zygosity test is a valuable tool for expectant mothers, offering clarity on whether their twins are identical or fraternal. By providing essential information about the pregnancy and the babies' genetics, this test helps ensure better care and preparation for the challenges and joys of raising twins. If you're expecting twins, talking to your healthcare provider about the benefits of a zygosity test could be a crucial step toward a healthier, more informed pregnancy.

 

 

 

Connecting Webinars to Action Steps in Louisiana

 

Blog Post by Caroline Brazeel from Louisiana

 

Every Woman Southeast is having an incredibly positive impact on my personal and professional life through its meaningful webinars and support from my colleagues in other states. Its the fact that we are a regional organization of local people that makes us uniquely poised to impact change. Heres one example of how EWSE pops into my life at random and opportune moments:

 

I spent some of the last moments of 2013 talking about Jamila Batts and Dr. Kimberlle Wyche-Etheridges October EWSE webinar. After a great NYE dinner, one of the guests, an architect, began describing his most recent work project a redesign of some of New Orleans public schools. In an effort to design a building that met the needs of the students, parents, teachers and school board, he had immersed himself in the lives of the people that flowed into and out of the school. He found old pictures of the buildings faade from the early twentieth century and attended community meetings where neighbors voiced concerns and parents expressed their hopes for the new building. He took that information and thoughtfully proposed options to the school board for adapting the existing structure to meet the current and future needs of those who use it.

 

His process of reaching into archives for an explanation of how the school became what it is today evoked Dr. Wyche-Etheridges work on the Nashville CityMatCH Racial Healing project. When I told him about how they worked in Nashville to map the history of one neighborhoods development, he couldnt wait to get home and look it up on the EWSE site. To him, the Nashville project was a combination of his interest in urban planning, architecture, and social justice. To me, his work was a window into how the physical infrastructure for school health and wellness is shaped. At work, I dont spend any time talking to architects, but our conversation made me realize I needed to reexamine my definition of non-traditional partners.

 

Im not sure I would have seen the connection between architecture, education and public health as clearly had I not heard Dr. Wyche-Etheridge and Ms. Batts speak about their work in Tennessee. What I know for sure is we have to ask the right questions of the right people to know how to go about doing our work differently. In 2014, Im hoping to work on the expansion of my definition of non-traditional partners, and I know my EWSE colleagues will help guide me in that pursuit.

 

Caroline works at the Louisiana Department of Health and Hospitals in the Office of Public Health. She is a member of the EWSE Leadership Team.

 

Jessica Hardy is Leading the Way in Alabama

 

Happy New Year Everyone!

 

Jessica Hardy is a very active and engaged member of the EWSE leadership team. She is a registered nurse, with an advanced degree in public health from the University of Alabama, Birmingham (UAB). She has served more than nineteen years with the Alabama Department of Public Health in various capacities, including the Alabama Womens Health Liaison for the U. S. Department of Health and Human Services and for the Centers for Disease Control and Prevention. Jessica was appointed to serve as the first Director for the Alabama Office of Womens Health (OWH) in 2002 (a position she continues to hold), and was appointed as Acting Director of Alabamas office of Minority Health from 2009 to 2012. In addition to her work and volunteering with EWSE, Jessica is currently a doctoral candidate in the Doctor of Nursing Practice (DNP) program at Troy University, in Alabama. We asked Jessica about the health problem she cares the most about as well as about the favorite part of her work and her favorite book. Here are her responses!

 

Infant mortality is a concern not only for Alabama but for the nation as a whole. In Alabama the infant mortality rate is higher than the national average and is compounded with a very daunting disparate rate between the white and black infant mortality rate. It has been said that the infant mortality rate reflects the health of a community; in Alabama this is one of our top women's health issues today. What I love most about my current responsibilities is the outreach into the community. My work allows me to advocate for health in general, and preventive health programs in particular. Communities are very receptive to shared health information. I enjoy serving as liaison between public health and the communities across our state. One of my favorite books is by Christine Northrop, Women's Bodies Women's Wisdom. I have found that women in the community can often relate to the information Dr. Northrop shares in her books, and it opens the door for me to introduce additional resources to the women in communities across Alabama.

 

 

 

 

 

From the Field: Health Care Law's Positive Impact on Women

 

Making Change Happen in Florida

 

Leah Barber-Heinz is the CEO of Florida CHAIN

 

Lost in all of the political wrangling over the Affordable Care Act is the fact that Floridas women, an astounding 1.4 million of whom are uninsured, will see a huge positive impact thanks to these reforms.

 

The new law creates significant cost savings by eliminating annual and lifetime limits on how much insurance companies cover if women get sick, as well as prohibiting insurers from dropping women from coverage when they fall ill. Moreover, plans in the new health exchanges place a cap on how much insurance companies can force women to pay in co-pays and deductibles. Starting in 2014 women who cannot afford quality health insurance will be provided tax credits, and the Act will completely close the donut hole for prescription drugs by 2020.

 

The law also provides more and better health care options and ensures coverage of basic health services including maternity benefits. Maternity benefits are often not provided in health plans offered through the individual insurance market.

 

Also of particular relevance to women is the fact that the new law already prohibits insurance companies from denying children coverage based on preexisting conditions. Moving forward, it will prohibit insurance companies from denying any woman coverage because of a pre-existing condition, excluding coverage of that condition, or charging more because of health status or gender. Right now, a healthy 22-year-old woman can be charged premiums 150 percent higher than a 22-year-old man.

 

The Affordable Care Act also aims to crack down on excessive insurance overhead by limiting how much insurance companies spend on nonmedical costs such as executive salaries and marketing. And insurance carriers must justify their premium increases in order to remain eligible for the health exchanges.

 

The positive impact these reforms will have on Floridas women and their families cannot be overstated. A recent report by Families USA found that more than 70 percent of consumers in the individual market will be eligible for financial assistance through the Marketplaces, because they either qualify for tax credits that will make their coverage more affordable or for Medicaid.

 

As a result of these and other important reforms included in the Affordable Care Act, fewer Florida women will delay needed care or be forced to give up basic necessities in order to get the health care they need.

 

 

Voices from the Field: Callie Womble, Intern Extraordinaire

Hello Blog World! My name is Callie Womble and I'm a Masters of Public Health student in the Health Behavior Department at the University of North Carolina Gillings School of Global Public Health. My graduate program focuses on the social and behavioral sciences as a means of understanding and improving the health of populations. One of my academic passions is minority womens health. I enjoy brainstorming innovative ways to improve wellness and reduce disparity. I first got involved with womens health in undergrad when I co-founded the UNC Chapel Hill chapter of the Office of Minority Healths Preconception Peer Educator program and interned at NARAL Pro-Choice North Carolina . These experiences were invaluable to me because they introduced me to the Maternal and Child Health (MCH) field, and ignited my passion.

 

As a graduate student, I wanted to build on that foundation and gain more research experience. In May of this year I began my practicum at the UNC Center for Maternal and Infant Health . My main responsibility has been to disseminate the Womens Voices Survey , and analyze its results. Working on the Womens Voices survey was a great because it directly addresses health disparities (an issue near and dear to my heart) and has given me a chance to sharpen my data collection, management and analysis skills.

 

At the end of August we closed the Womens Voices survey with 1,950 responses from women of all nine EWSE states and our sample truly represented a life course perspective engaging women of all ages. (How awesome is that?!) Analyzing the data has been incredibly fulfilling the survey validates the stories of women in our region. The daily lived experiences of Southeastern women matter, and this survey both affirmed the women as individuals and provided a space for them to share how they see the world. For me, the most thought-provoking aspect of the data analysis was coding the qualitative responses to questions asking women what they need in order to improve their health. Some of the quotes that really got my attention included:

 

I need an accountability partner. I have the tendency to procrastinate and put other's needs before my own. I need a gently forceful person to make sure I'm doing what I'm supposed to do.

 

More education and support on how to balance the many competing demands that women face today with work, family, friends, etc.

to have doctors treat me as a human and not just as a poor-Medicaid recipient.

A practitioner that listens.

A better job so I didn't have to work so hard. More time. I feel like a lot of my health issues stem from my lack of time to do things like prepare meals and exercise. I work a lot, so that doesn't leave much time for me.

Access for the African American population, especially those in rural areas. Transportation is an issue. Fear is another issue. Cost factors in. Prescription costs prevent consistent medication being used.

 

These quotes remind me that women in our region often have many responsibilities. They are moms, daughters, friends, sisters, employees, students, church members, sorority members, girlfriends, wives and the proverbial list of hats women wear goes on and on. Subsequently, prioritizing others needs above their own is a current norm for most women. It also reminds me that the social determinants of health (e.g. where you live, work, play and pray) are REAL and they truly impact how women experience life and wellness. In order to create lasting change we as public health professionals need to strategize ways to make self-care for women the default choice, as well as ways to positively influence the social determinants of womens health. Indeed, this is a tall order but its necessary to change the status quo.

 

As my practicum comes to close, I have started to reflect on all I have learned these past six months. While the technical skills are indeed significant to me, what resonates most to me about my practicum is the well-rounded nature of my experience. From meetings with stakeholders, to capacity development webinars, to daily in-office conversations with my supervisor and the fellow staff, this experience has been a total emersion in all things MCH. Ive learned countless new jargon, discovered new thought leaders and followed intense political legislation alongside my fellow staff.

 

The most meaningful part of my practicum has been interacting with professionals from different disciplines. It has been both informative and rewarding to hear about womens health issues from their perspective and then share my thoughts from the HB point of view. These interactions have highlighted how all disciplines have significant expertise necessary for accomplishing our shared goal: improve the health of populations. By working together we are able to put the different pieces of the puzzle together, have a collective impact and achieve our shared goal. Although my practicum is ending, I am excited to continue this versatile experience of personal and professional development as a part of the EWSE leadership team . As a North Carolina partner I am looking forward to continuing our work towards health equity in our region.