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Table 1 Developmental Outcomes following laser for TTTS (subset of published studies)

From: Twin-to-twin transfusion syndrome neurodevelopmental follow-up study (neurodevelopmental outcomes for children whose twin-to-twin transfusion syndrome was treated with placental laser photocoagulation)

Author and year

Number and age of participants

Measures

Outcomes

Campos, D., et al., (2016) [35]

N = 33 monochorionic diamniotic twins (post-laser), and N = 22 term singletons Birth to 12 months, corrected for prematurity

Bayley Scales of Infant Development, Clinical examination of TTTS group. Two assessments, in first and second 6 months of life.

Cerebral palsy in 18%, strabismus in 9%, microcephaly in 3% of TTTS group. Significant difference between groups in prevalence of cognitive and fine motor deficits apparent by 6 months (greater risk in TTTS group); by 12 months, significantly greater prevalence of deficits in all domains for TTTS group Comparative results at second assessment not provided (table of first assessment repeated in error). Donors 7 times increased risk of adverse outcomes c.f. recipients; donor status and low socioeconomic status, and cardiorespiratory disease were associated with poorer expressive communication & fine motor skills respectively

Müllers, S. et al., (2015) [36]

N = 106 (post-laser). Median age 4 years (range 6 mo – 7 yrs) (correction for prematurity not specified)

Individual correspondence and paediatric evaluation (details not specified)

Ongoing neurodevelopmental concerns in 14% (speech and language concerns n = 7, behavioural concerns n = 2, mild motor delay n = 2, mild cerebral palsy n = 2, major cerebral palsy n = 2)

Tosello, B. et al., (2014) [29].

N = 35 (post-laser). Median age 37 months, mean 30 mo (range 4 mo - 5 yrs)

Neurological assessment at discharge from maternity hospital. Ages and Stages Questionnaire (ASQ) at up to 5 years

As neonates, ≈7% neurologically abnormal (≈93% normal). At follow-up, ≈31% abnormal based on ASQ (≈69% normal), ≈6% severely neurologically abnormal (cerebral palsy). Of children found to be abnormal at follow-up, 45% had not been detected on routine medical review. Donor status and birth < 32 weeks significantly associated with adverse neurosensory outcome as neonates. No correlations at follow-up between outcome and donor status, severity of TTTS or other variables (but small numbers)

Sago, H. et al., (2010) [37]

N = 275 (post-laser). Age 6 months (correction for prematurity not specified)

Review of cerebral imaging & clinical assessment by paediatrician (details not specified)

Major neurological disability in ≈5% (severe IVH, cystic PVL, CP, hydrocephalus, ventriculomegaly, or multiple infarcts)