Long-term outcome of infants with twin-to-twin transfusion syndrome.
OBJECTIVE
To clarify the long-term neurodevelopmental outcome of twin-to-twin transfusion syndrome (TTTS) survivors.


METHODS
From January 1994 to December 2003, 33 newborns with TTTS who were derived from 18 monochorionic twin gestations were enrolled for the study. The development and growth at 3 or 6 years of age were compared between TTTS survivors and weight-matched singleton controls.


RESULTS
The mortality in TTTS (8/33: 24%) was significantly higher than that of the controls (7/80: 9%). Of all 12 TTTS patients who were diagnosed before 25 weeks and born before 28 weeks of gestation, in 10 (83%) it led to neonatal or intrauterine death. The morbidity of cerebral palsy, epilepsy, and mental retardation did not differ between TTTS and control patients. The morbidity and severity of neurological deficits at school age were similar in both groups. No growth parameters at 3 or 6 years of age differed between TTTS and controls.


CONCLUSIONS
Morbidity, growth and development of TTTS survivors attained comparable levels of weight-matched controls, despite the higher neonatal mortality. These results suggest that the early management of TTTS is critical for refining the total outcome of the affected twins.
Hikino
Shunji
S
Perinatal and Maternity Care Unit, Kyushu University Hospital, Fukuoka, Japan. hikino@pediatr.med.kyushu-u.ac.jp
Ohga
Shouichi
S
Kanda
Takashi
T
Nakashima
Toshinori
T
Yamamoto
Junko
J
Nakayama
Hideki
H
Nakano
Hitoo
H
Hara
Toshiro
T
D002657:Child Development / Q000502:physiology*; D005260:Female; D005330:Fetofetal Transfusion / Q000401:mortality / Q000503:physiopathology*; D006128:Growth / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007360:Intelligence / Q000502:physiology; D008137:Longitudinal Studies; D009420:Nervous System / Q000254:growth & development; D011247:Pregnancy