Twins and Child Abuse

An increased incidence of child abuse and neglect has been documented surrounding twin births. Levy 1 wrote about an increased rate of infant mortality and failure to thrive in twins born into the modern Navajo culture. Robarge et al, 2 in a singleton-birth matched control study, showed an increased incidence of abuse in families after the birth of twins, both in siblings of the twins and in the twins. In a related study, Groothuis et al 3 documented that twin births are associated with a high incidence of perinatal complications that also predispose to abuse. When regression analysis was used to control for perinatal complications, twin status itself was found to be a risk factor for subsequent abuse, presumably owing to the many family stresses imposed by twin births. Nelson and Martin 4 found an increased incidence of abuse among twin pairs. Both twins of a pair were abused 60%