No abstract

Premature TTTS newborns treated with fetal laser therapy had similar survival and neurodevelopmental outcomes compared to preterm di-di twins without TTTS.

BACKGROUND Twin pregnancies and fetal therapies are associated with increased risk of preterm delivery. Limited literature exists on outcomes for extremely preterm infants born in the context of a pregnancy complicated with twin-twin transfusion syndrome (TTTS). OBJECTIVES To compare mortality of preterm newborns who received laser therapy for TTTS to preterm controls born in the context of a dichorionic-diamniotic (di-di) pregnancy. Secondary outcomes are: short-term neonatal morbidities and neurodevelopmental measures at 18 months of corrected gestational age (cGA). DESIGN/METHODS Case-control retrospective study of all twins infant born <29 weeks of gestation between 2006 and 2015 at Sainte-Justine Hospital. Preterm with TTTS and fetal laser therapy were compared to preterm di-di twins. Survival analysis was done using Cox proportional regression model. RESULTS Thirty-three preterms with TTTS (TTTS-laser group) were compared to 101 preterms without TTTS (non-TTTS group). Demographic data and comparisons for short-term morbidities are presented in Table 1. TTTS status was not associated with increased mortality when adjusting for birth weight and antenatal steroids (Table 2). No differences were found for Bayley-3rd edition score, cerebral palsy, vision impairment, hearing impairment and growth parameters at 18-month cGA. CONCLUSION Extremely premature newborns exposed to fetal laser therapy due to TTTS had similar survival and neurodevelopmental outcomes compared to contemporaneous extremely preterm di-di twins.