Jeanine M M van Klink1, Hendrik M Koopman2, Erik W van Zwet3, Johanna M Middeldorp4, Frans J Walther1, Dick Oepkes4, Enrico Lopriore1. 1. Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands. 2. Department of Clinical Psychology, Faculty of Social Sciences, Leiden University Medical Center, Leiden, the Netherlands. 3. Department of Biostatistics, Leiden University Medical Center, Leiden, the Netherlands. 4. Department of Obstetrics, Leiden University Medical Center, Leiden, the Netherlands.
Abstract
OBJECTIVE: To compare the incidence of neurodevelopmental impairment in surviving children from pregnancies with twin-twin transfusion syndrome (TTTS) treated with laser surgery between 2 time periods. STUDY DESIGN: We compared the neurodevelopmental outcome between the first consecutive cohort of TTTS pregnancies treated with laser surgery from 2000 to 2005, with a cohort treated between 2008 and 2010. Neurologic, cognitive, and motor development was evaluated using Bayley scales at 2 years of age corrected for prematurity. RESULTS: A total of 229 twin pregnancies were treated with laser surgery, 113 in the first cohort and 106 in the recent cohort. Overall survival increased from 70% (158/226) to 80% (170/212) (P = .014). The incidence of neurodevelopmental impairment decreased from 18% (28/152) to 6% (10/155) (P < .01). In multivariate analysis, severe cerebral injury at birth was independently associated with neurodevelopmental impairment (odds ratio, 34.86; 95% confidence interval, 11.83-102.75; P < .01). CONCLUSION: Overall survival in TTTS has improved over time, with a concomitant reduction in the incidence of neurodevelopmental impairment. Research focused on prevention of cerebral injury is needed to further improve outcomes of these complicated twin pregnancies.
OBJECTIVE: To compare the incidence of neurodevelopmental impairment in surviving children from pregnancies with twin-twin transfusion syndrome (TTTS) treated with laser surgery between 2 time periods. STUDY DESIGN: We compared the neurodevelopmental outcome between the first consecutive cohort of TTTS pregnancies treated with laser surgery from 2000 to 2005, with a cohort treated between 2008 and 2010. Neurologic, cognitive, and motor development was evaluated using Bayley scales at 2 years of age corrected for prematurity. RESULTS: A total of 229 twin pregnancies were treated with laser surgery, 113 in the first cohort and 106 in the recent cohort. Overall survival increased from 70% (158/226) to 80% (170/212) (P = .014). The incidence of neurodevelopmental impairment decreased from 18% (28/152) to 6% (10/155) (P < .01). In multivariate analysis, severe cerebral injury at birth was independently associated with neurodevelopmental impairment (odds ratio, 34.86; 95% confidence interval, 11.83-102.75; P < .01). CONCLUSION: Overall survival in TTTS has improved over time, with a concomitant reduction in the incidence of neurodevelopmental impairment. Research focused on prevention of cerebral injury is needed to further improve outcomes of these complicated twin pregnancies.
Authors: Marjolijn S Spruijt; Ellen Tameeris; De-Peng Zhao; Johanna M Middeldorp; Monique C Haak; Dick Oepkes; Enrico Lopriore Journal: Fetal Diagn Ther Date: 2017-03-11 Impact factor: 2.587
Authors: Marjolijn S Spruijt; Enrico Lopriore; Ratna N G B Tan; Femke Slaghekke; Frans J C M Klumper; Johanna M Middeldorp; Monique C Haak; Dick Oepkes; Monique Rijken; Jeanine M M van Klink Journal: J Clin Med Date: 2019-08-15 Impact factor: 4.241
Authors: Manon Gijtenbeek; Monique C Haak; Tom J P Huberts; Johanna M Middeldorp; Frans J C M Klumper; Femke Slaghekke; Enrico Lopriore; Dick Oepkes; Jeanine M M van Klink Journal: Prenat Diagn Date: 2020-04-15 Impact factor: 3.050
Authors: Fiona L Mackie; Helen Pattison; Jelena Jankovic; R Katie Morris; Mark D Kilby Journal: BMC Pregnancy Childbirth Date: 2019-12-31 Impact factor: 3.007