The hypothesis proposed by Knox (1970) that an anencephalic fetus arises from a fetus-fetus interaction between two dizygous twins predicts that the twinning rate, the population incidence of anencephalus, and the female proportion of anencephalics in a population should be positively interrelated. These associations were tested using Canadian data during a long period of time and over a large geographical area. The results did not support the hypothesis.
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