Neurodevelopmental outcome and risk factors for disability for twin-twin transfusion syndrome treated with laser
Peter H Gray1, Leith Poulsen, Kristen Gilshenan
1Growth and Development Unit, Mater Mothers' Hospital, South Brisbane, Queensland, Australia. Peter.Gray@mater.org.au
Objective:
This study was performed to report the neurodevelopmental outcome of survivors of twin-twin transfusion syndrome (TTTS) treated with laser surgery and to determine the risk factors for neurodevelopmental disability.
Study Design:
A prospective study of TTTS cases treated with laser was performed. Survivors were assessed at 2 years corrected for prematurity. Neurodevelopmental disability was defined as the presence of cerebral palsy, deafness, blindness, or cognitive impairment with a developmental score >2 SDs below the mean.
Results:
A total of 75 TTTS pregnancies were treated with a perinatal survival rate of 79.3%. A total of 113 survivors were assessed. The rate of cerebral palsy was 4.4% and cognitive impairment was 8%, with a neurodevelopmental disability rate of 12.4%. Quintero stage was the only independent risk factor for neurodevelopmental disability.
Conclusion:
The incidence of neurodevelopmental disability in TTTS survivors treated with laser is considerable, with Quintero stage being an independent risk factor.
