The identical-twin transfusion syndrome: A source of error in estimating IQ resemblance and heritability

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Abstract
Among identical twins, lower birthweight is associated with lower adult intelligence. However, no such relation between birthweight and adult IQ exists among fraternal twins. A likely explanation for the association between birthweight and intelligence among identical twins is the identical twin transfusion syndrome which occurs only between some monochorionic identical twin pairs. The IQ scores from separated identical twins were reanalyzed to explore the consequences of identical twin transfusion syndrome for IQ resemblance and heritability. Among 129 published cases of identical twin pairs reared apart, 76 pairs contained some birthweight information. These 76 pairs were separated into 3 classes: 23 pairs in which there was clear evidence of a substantial birthweight difference (indicating the probable existence of the identical twin transfusion syndrome), 27 pairs in which the information on birthweight was ambiguous, and 26 pairs in which there was clear evidence that the twins were similar in birthweight. The reanalyses showed birthweight differences are positively associated with IQ differences in the total sample of separated identical twins. Within the group of 23 twin pairs who showed large birthweight differences, there was a positive relation between birthweight differences and IQ differences. When heritability of IQ is estimated for those twins who do not suffer large birthweight differences, the resemblance of the separated identical twins'' IQ is 0.95. Given that the average reliability of the individual IQ test is around 0.95, genetic factors and errors of measurement cause the individual differences in IQ among human beings. Because of the identical twin transfusion syndrome, previous studies of MZ twins have underestimated the effect of genetic factors on IQ. An analysis of the IQs for heavier and lighter birthweight twins suggests that the main effect of the identical twin transfusion syndrome is to lower the IQ of the lighter birthweight twin, rather than to raise the IQ of the more fortunate partner or to influence the IQ of both members. Postnatal cultural and social environment may produce little of the total phenotypic variation in IQ found in the normal population. In the future, investigators who use twin studies to estimate heritability must ascertain whether their identical twin pairs suffered from the identical twin transfusion syndrome. Accurate estimates of heritability can only be obtained using identical twins who do not suffer from placental circulation problems. Most likely, the identical twin transfusion syndrome produces anoxia and brain damage during early prenatal development in the smaller identical twin. The anoxia is caused by a lowering of the Hb content of the smaller twin by 35% or more.