Laser Surgery for Twin-to-Twin-Transfusion-Syndrome and Behavioral Outcomes at 2 Years
BACKGROUND AND PURPOSE:
Brandsma et al. (Arch Dis Child Fetal Neonatal Ed., 2019) sought to determine behavioral outcomes and related risk-factors in Twin-to-Twin-Transfusion-Syndrome (TTTS) survivors following laser treatment
Observational cohort study
TTTS survivors in The Netherlands
Undergoing behavioral assessment at 2 years
Parents completed the Child Behavior Checklist for their twins
Antenatal, neonatal and follow-up data were collected
Bayley III and a neurological exam derived from the database
Incidence of behavioral problems
Risk factors for behavioral problems
417 Child Behavior Checklist questionnaires were completed (81% of eligible children)
Mean gestational age at birth: 32.8 weeks
No difference in total behavioral problems between TTTS group and general Dutch population (p=0.12)
TTTS group: 8%
General population: 10%
Whether the twin was the “donor” or the “recipient” before TTTS treatment did not alter results (p=0.84)
Severe neurodevelopmental impairment was more frequent in the children with behavioral problems
High maternal educational level was associated with lower behavioral problem scores (p=0.01)
TTTS laser treatment is not associated with more behavioral problems at 2 years of age
Behavior problems were more frequent in twins with severe neurodevelopmental impairment and the authors state
This finding suggests that caregivers and healthcare professionals need to be aware of comorbid behavioural problems in children with severe impairments including cognitive and motor delay
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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