OBJECTIVE: To identify risk factors for cerebral lesions among survivors of twin-twin transfusion syndrome treated with laser surgery. STUDY DESIGN: A multilevel regression analysis examined risk factors for neonatal cerebral lesions identified by imaging. Imaging was routine in "high-risk survivors," defined as those delivered at <32 weeks' gestation, and by clinical indications if born later. Severe lesions were defined as: intraventricular hemorrhage grade III-IV, cystic periventricular leukomalacia, ventriculomegaly and/or hydrocephalus, microcephaly, infarctions, porencephalic/Dandy-Walker cysts, or bilateral other cysts. RESULTS: For 262 consecutive laser-treated twin-twin transfusion syndrome patients, 18 neonates had severe lesions identified among 427 individual survivors (4.2%) and 242 "high-risk survivors" (7.4%). Forty-six newborns had any cerebral lesion, resulting in lesion rates of 10.8%-19.0%. Delivery <32 weeks' (odds ratio, 4.95; P < .001) and <28 weeks' (odds ratio, 6.25; P < .001) gestation were associated with increased likelihood of any cerebral lesion. CONCLUSION: This cohort showed low rates (4-7%) of severe neonatal cerebral lesions, with prematurity being the primary risk factor.
OBJECTIVE: To identify risk factors for cerebral lesions among survivors of twin-twin transfusion syndrome treated with laser surgery. STUDY DESIGN: A multilevel regression analysis examined risk factors for neonatal cerebral lesions identified by imaging. Imaging was routine in "high-risk survivors," defined as those delivered at <32 weeks' gestation, and by clinical indications if born later. Severe lesions were defined as: intraventricular hemorrhage grade III-IV, cystic periventricular leukomalacia, ventriculomegaly and/or hydrocephalus, microcephaly, infarctions, porencephalic/Dandy-Walker cysts, or bilateral other cysts. RESULTS: For 262 consecutive laser-treated twin-twin transfusion syndromepatients, 18 neonates had severe lesions identified among 427 individual survivors (4.2%) and 242 "high-risk survivors" (7.4%). Forty-six newborns had any cerebral lesion, resulting in lesion rates of 10.8%-19.0%. Delivery <32 weeks' (odds ratio, 4.95; P < .001) and <28 weeks' (odds ratio, 6.25; P < .001) gestation were associated with increased likelihood of any cerebral lesion. CONCLUSION: This cohort showed low rates (4-7%) of severe neonatal cerebral lesions, with prematurity being the primary risk factor.
Authors: Enrico Lopriore; Gerda van Wezel-Meijler; Johanna M Middeldorp; Marieke Sueters; Frank P Vandenbussche; Frans J Walther Journal: Am J Obstet Gynecol Date: 2006-04-21 Impact factor: 8.661
Authors: Rubén A Quintero; Jan E Dickinson; Walter J Morales; Patricia W Bornick; Carlos Bermúdez; Robert Cincotta; Fung Yee Chan; Mary H Allen Journal: Am J Obstet Gynecol Date: 2003-05 Impact factor: 8.661
Authors: Marie-Victoire Senat; Jan Deprest; Michel Boulvain; Alain Paupe; Norbert Winer; Yves Ville Journal: N Engl J Med Date: 2004-07-06 Impact factor: 91.245
Authors: Rudolf Ascherl; Ina Sorge; Ulrich Thome; Franz Wolfgang Hirsch; Annett Bläser; Wieland Kiess; Andreas Merkenschlager Journal: Childs Nerv Syst Date: 2017-10-02 Impact factor: 1.475