From DNA to postal code: Reasons and theories on how multiple sets of twins are born

In May 2014, Roger Federer made news, not for another tennis record, but because he became the father of twins for the second time. Roger and wife Mirka Federer, welcomed their twin boys, Leo and Lennart, almost five years after their twin girls, Myla Rose and Charlene Riva, were born.

Two weeks ago, former beauty queen Celina Jaitly announced that she and husband Peter Haag are expecting twins. They are already parents to five-year-old twin boys, Winston and Viraaj.

The occurrence is just as much fascinating as it is intriguing. How common is this phenomenon? “The exact incidence of repeat twin pregnancy is not known. However, the chances are seen among women who have been pregnant with twins in the past. Regional variations are also observed. For example, Kodinhi (Malappuram), a village in Kerala has almost 500 [sets of] twins,” says Dr Alka Kumar, consultant gyneacologist, SL Raheja Fortis, Mahim.

While Malappuram’s already famous for its teakwood plantations and ancient temples, a chance observation about the number of fellow twins in their classroom by two students — Sameera and Femeena —brought the spotlight on the twin boom in Kodinhi.

“At present we have about 600 [pairs of] twins. The oldest pair is 75 years old,” says Bhaskaran Pullani, a civil contractor and the chairman of Twins and Kins Association, Kodinhi. The pride in his voice is tangible as he goes on to say, “I have twin boys too. They both are engineers.”

The village also has six families with double sets of twins and two families with triplets. Bhaskaran adds that one family was expecting a third set of twins but it ended in natural abortion.

Geography or biology?

While it is a fact that genes play a role in the conception of twins, speculations about the role of geography in the birth of twins continue. Apart from Kodinhi, the village of Cândido Godói in Brazil and the town of Igbo-Ora in Oyo, Nigeria, too, are well-known for the heavy concentration of twins in its population.

The research on the relation between geography and twin births is yet to give solid answers. But the biological aspect is explained as this: “Genetic predisposition [to bearing twins] is seen to some extent in monozygotic twins (derived from a single ovum, and therefore identical) as compared to dizygotic twins (derived from two separate ova, and therefore aren’t identical). The tendency is more familial particularly from the maternal side; twinning is more common in older and multiparous women.”

Bhaskaran finds it hard to believe that genes have anything to do with the birth of his twins. “Twins haven’t been born in mine or my wife’s family for three generations. My sons are the first,” he says. His wife Remabhai, a biology teacher, adds, “Many people have come here to do research. But no one has told us the reason behind it.”

Double trouble

Twin pregnancy is not only difficult for the mother but also puts the babies at risk, both before and after their birth. In the case of mothers, the physical difficulties such as stretching of skin, swelling of legs, gastric effect, acidity, morning sickness and back pain are aggravated. Chances of pre-term delivery, caesarean section and difficult labour also increase.

Twin babies are more fragile and are often born premature. They tend to have lower birth weight. They also face more complications at birth. This could make them more susceptible to many long-term health problems.

Experts’ tips for mums carrying twins:

1. Take adequate rest at home from the fifth month of pregnancy to prevent pre-term labour.

2. Avoid coitus after the fourth month, as chances of abortion are very high during this time.

3. Go for regular blood investigations, sonography and ante-natal check-ups.

4. Take medication only on doctor’s advice.

5. Eat healthy, exercise regularly and sleep well.

6. Practice mindfulness.

With inputs from Dr Bandita Sinha, gynaecologist and director, World of Women, Vashi.

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The author tweets @iamsusanjose