Neurodevelopmental outcome and risk factors for disability for twin-twin transfusion syndrome treated with laser surgery.
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.


METHODS
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.


CONCLUSIONS
The incidence of neurodevelopmental disability in TTTS survivors treated with laser is considerable, with Quintero stage being an independent risk factor.
Growth and Development Unit, Mater Mothers' Hospital, South Brisbane, Queensland, Australia. Peter.Gray@mater.org.au
Peter H
PH
Gray
Leith
L
Poulsen
Kristen
K
Gilshenan
Barbara
B
Soong
Robert B
RB
Cincotta
Glenn
G
Gardener
D002547:Cerebral Palsy / Q000453:epidemiology* / Q000209:etiology; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005330:Fetofetal Transfusion / Q000150:complications / Q000601:surgery; D005332:Fetoscopy; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D053685:Laser Therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome