Long-term developmental follow-up of infants who participated in a randomized clinical trial of amniocentesis vs laser photocoagulation for the treatment of twin-to-twin transfusion syndrome.
OBJECTIVE
We sought to assess long-term neurodevelopment of children who were treated prenatally as part of the Eurofoetus randomized controlled trial.


METHODS
The study population was composed of 128 cases of twin-to-twin transfusion syndrome (TTTS) included and followed up in France. Survivors were evaluated by standardized neurological examination and by Ages and Stages Questionnaires (ASQ). Primary outcome was a composite of death and major neurological impairment.


RESULTS
A total of 120 children (47%) were alive at the age of 6 months and were followed up to the age of 6 years. At the time of diagnosis, only treatment and Quintero stage were predictors of a poor outcome (hazard ratio, 0.61; 95% confidence interval, 0.41-0.90; P = .01 and hazard ratio, 3.23; 95% confidence interval, 2.19-4.76; P < .001, respectively). Children treated by fetoscopic selective laser coagulation (FSLC) had higher ASQ scores at the end of follow-up (P = .04).


CONCLUSIONS
FSLC was significantly associated with a reduction of the risk of death or long-term major neurological impairment at the time of diagnosis and treatment.
Department of Obstetrics and Gynecology, Université Paris Descartes, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, 149 Rue de Sèvres, Paris Cedex 15, France.
Laurent J
LJ
Salomon
Lisa
L
Ortqvist
Philippe
P
Aegerter
Laurence
L
Bussieres
Stéphanie
S
Staracci
Julien J
JJ
Stirnemann
Mohamed
M
Essaoui
Jean-Pierre
JP
Bernard
Yves
Y
Ville
D000649:Amniocentesis; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D005330:Fetofetal Transfusion / Q000601:surgery; D005332:Fetoscopy; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D017075:Laser Coagulation; D008297:Male; D009483:Neuropsychological Tests; D016896:Treatment Outcome