| Autor: |
Marjolijn S. Spruijt, Enrico Lopriore, Ratna N.G.B. Tan, Femke Slaghekke, Frans J.C.M. Klumper, Johanna M. Middeldorp, Monique C. Haak, Dick Oepkes, Monique Rijken, Jeanine M.M. van Klink |
| Jazyk: |
angličtina |
| Rok vydání: |
2019 |
| Předmět: |
|
| Zdroj: |
Journal of Clinical Medicine, Vol 8, Iss 8, p 1226 (2019) |
| Druh dokumentu: |
article |
| ISSN: |
2077-0383 |
| DOI: |
10.3390/jcm8081226 |
| Popis: |
Despite many developments in its management, twin-to-twin transfusion syndrome (TTTS) remains an important risk factor for long-term neurodevelopmental impairment (NDI). Our objective was to compare the incidence of severe NDI in a recent cohort of TTTS survivors, treated with laser surgery from 2011 to 2014, with a previous cohort treated from 2008 to 2010. Neurological, cognitive, and motor development were assessed at two years of age. We determined risk factors associated with Bayley-III scores. Severe NDI occurred in 7/241 (3%) survivors in the new cohort compared to 10/169 (6%) in the previous cohort (p = 0.189). Disease-free survival (survival without severe impairment) did not significantly differ. Low birth weight and being small for gestational age (SGA) were independently associated with lower cognitive scores (both p < 0.01). Severe cerebral injury was related to decreased motor scores (B = −14.10; 95% CI −3.16, −25.04; p = 0.012). Children with severe NDI were born ≥32 weeks’ gestation in 53% of cases and had no evidence of cerebral injury on cranial ultrasound in 59% of cases. Our results suggest that improvement in outcome of TTTS has reached a plateau. Low birth weight, SGA, and cerebral injury are risk factors for poor neurodevelopmental outcome. Neither gestational age above 32 weeks nor the absence of cerebral injury preclude severe NDI. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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