Andrew H Chon1, Mary Rose Mamey2, Sheree M Schrager2, Douglas L Vanderbilt3, Ramen H Chmait1. 1. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 2. Department of Pediatrics, Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA. 3. Department of Pediatrics, Division of General Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Abstract
OBJECTIVE: To determine the relationship between preoperative fetal head circumference (HC) and cognitive performance among children treated with laser surgery for twin-twin transfusion syndrome (TTTS). METHODS: Donor and recipient twin HCs were measured preoperatively (16-26 weeks' gestation) and at 2 years corrected age. Multilevel multivariate regression models were used to test pregnancy and child-level risk factors for lower Battelle Developmental Inventory Second Edition (BDI-2) scores. A repeated-measures ANOVA was used to examine HC growth among recipients and donors between preoperative and 2 years. RESULTS: Ninety-nine children were evaluated. The average BDI-2 score for the cohort was 101.4 (SD = 12.2). After controlling for covariates, larger preoperative HC percentiles were significantly associated with an increase in total BDI-2 scores (β = 0.29; P < 0.001), where a 12.5% increase in preoperative HC percentile was associated with 1-point increase in total BDI-2 score. The mean recipient and donor twin HC percentiles preoperatively and at age 2 years were 51st percentile vs 20th percentile (P = .050) and 60th percentile vs 49th percentile (P = .676), respectively. CONCLUSION: Smaller preoperative HC percentiles identified children at risk of lower, but still within normal range, total BDI-2 scores. The discordance in HC percentiles between the donor and recipient twin decreased after laser surgery.
OBJECTIVE: To determine the relationship between preoperative fetal head circumference (HC) and cognitive performance among children treated with laser surgery for twin-twin transfusion syndrome (TTTS). METHODS:Donor and recipient twin HCs were measured preoperatively (16-26 weeks' gestation) and at 2 years corrected age. Multilevel multivariate regression models were used to test pregnancy and child-level risk factors for lower Battelle Developmental Inventory Second Edition (BDI-2) scores. A repeated-measures ANOVA was used to examine HC growth among recipients and donors between preoperative and 2 years. RESULTS: Ninety-nine children were evaluated. The average BDI-2 score for the cohort was 101.4 (SD = 12.2). After controlling for covariates, larger preoperative HC percentiles were significantly associated with an increase in total BDI-2 scores (β = 0.29; P < 0.001), where a 12.5% increase in preoperative HC percentile was associated with 1-point increase in total BDI-2 score. The mean recipient and donor twin HC percentiles preoperatively and at age 2 years were 51st percentile vs 20th percentile (P = .050) and 60th percentile vs 49th percentile (P = .676), respectively. CONCLUSION: Smaller preoperative HC percentiles identified children at risk of lower, but still within normal range, total BDI-2 scores. The discordance in HC percentiles between the donor and recipient twin decreased after laser surgery.
Authors: F A Chervenak; P Jeanty; F Cantraine; U Chitkara; I Venus; R L Berkowitz; J C Hobbins Journal: Am J Obstet Gynecol Date: 1984-07-01 Impact factor: 8.661
Authors: S Passemard; L Titomanlio; M Elmaleh; A Afenjar; J-L Alessandri; G Andria; T Billette de Villemeur; O Boespflug-Tanguy; L Burglen; E Del Giudice; F Guimiot; C Hyon; B Isidor; A Mégarbané; U Moog; S Odent; K Hernandez; N Pouvreau; I Scala; M Schaer; P Gressens; B Gerard; Alain Verloes Journal: Neurology Date: 2009-09-22 Impact factor: 9.910
Authors: Ramen H Chmait; Andrew H Chon; Sheree M Schrager; Eftichia V Kontopoulos; Rubén A Quintero; Douglas L Vanderbilt Journal: Early Hum Dev Date: 2015-09-10 Impact factor: 2.079