TY - JOUR
T1 - Donor catch-up growth after laser surgery for twin-twin transfusion syndrome
AU - Chmait, Ramen H.
AU - Chon, Andrew H.
AU - Schrager, Sheree M.
AU - Kontopoulos, Eftichia V.
AU - Quintero, Rubén A.
AU - Vanderbilt, Douglas L.
N1 - Publisher Copyright:
© 2015 Elsevier Ireland Ltd.
PY - 2015
Y1 - 2015
N2 - Objective: To assess fetal growth after laser surgery for TTTS at the time of prenatal diagnosis, birth, and at 2. years of age. Design/methods: Growth data were collected from surviving children treated between 2007 and 2010 as part of a study to assess neurodevelopment at 24. months (±. 6. weeks) corrected age. Fetal weights were obtained via ultrasound using Hadlock's formula at the time of preoperative assessment for laser surgery. Birth weights were recorded by the staff at the delivering institutions. Weights at 2. years corrected age were recorded at the time of neurodevelopmental testing. Weights were converted into percentiles according to standard growth curves. Growth restriction was defined as <. 10th percentile for given age. Multilevel latent growth curve models in Mplus (twins nested in families) examined weight change over time as a function of donor status, and repeated measures ANOVA was utilized to assess in donor-recipient weight discordance over time for twin pairs. Results: 99 of 206 children (56 of 130 families) were studied. There were no differences between enrolled and non-enrolled patients in donor/recipient status and survival rates, fetal demise, intrauterine growth restriction, Quintero stage, and gestational age of surgery or delivery. 48.5% were donors. The median fetal, birth, and 2-year weights for all twins were 288. g, 1.9. kg, and 11.8. kg, respectively, and the overall prevalence of growth restriction was 28%, 22%, and 3%, respectively. Growth restriction rates at prenatal diagnosis were 56% in donors vs. 2% in recipients (OR = 64.3, p. < 0.001); at birth, 35% vs. 10% (OR. = 5.0, p. <. 0.01); and at 2. years, 6% vs. 0%. Donors showed significant gains in weight percentile (B = 13.1, p. < 0.001) and a significant decrease in growth restriction rates over time (B = - 1.6, p <. 0.001). Weight discordance between donor and recipient pairs also significantly decreased over time (linear F(1,42). = 54.34, p < 0.001). Conclusions: After laser surgery for TTTS, donor twins exhibit significant catch-up growth by two years of age.
AB - Objective: To assess fetal growth after laser surgery for TTTS at the time of prenatal diagnosis, birth, and at 2. years of age. Design/methods: Growth data were collected from surviving children treated between 2007 and 2010 as part of a study to assess neurodevelopment at 24. months (±. 6. weeks) corrected age. Fetal weights were obtained via ultrasound using Hadlock's formula at the time of preoperative assessment for laser surgery. Birth weights were recorded by the staff at the delivering institutions. Weights at 2. years corrected age were recorded at the time of neurodevelopmental testing. Weights were converted into percentiles according to standard growth curves. Growth restriction was defined as <. 10th percentile for given age. Multilevel latent growth curve models in Mplus (twins nested in families) examined weight change over time as a function of donor status, and repeated measures ANOVA was utilized to assess in donor-recipient weight discordance over time for twin pairs. Results: 99 of 206 children (56 of 130 families) were studied. There were no differences between enrolled and non-enrolled patients in donor/recipient status and survival rates, fetal demise, intrauterine growth restriction, Quintero stage, and gestational age of surgery or delivery. 48.5% were donors. The median fetal, birth, and 2-year weights for all twins were 288. g, 1.9. kg, and 11.8. kg, respectively, and the overall prevalence of growth restriction was 28%, 22%, and 3%, respectively. Growth restriction rates at prenatal diagnosis were 56% in donors vs. 2% in recipients (OR = 64.3, p. < 0.001); at birth, 35% vs. 10% (OR. = 5.0, p. <. 0.01); and at 2. years, 6% vs. 0%. Donors showed significant gains in weight percentile (B = 13.1, p. < 0.001) and a significant decrease in growth restriction rates over time (B = - 1.6, p <. 0.001). Weight discordance between donor and recipient pairs also significantly decreased over time (linear F(1,42). = 54.34, p < 0.001). Conclusions: After laser surgery for TTTS, donor twins exhibit significant catch-up growth by two years of age.
KW - Catch-up growth
KW - Growth restriction
KW - Laser surgery
KW - Twin-twin transfusion syndrome
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U2 - 10.1016/j.earlhumdev.2015.08.006
DO - 10.1016/j.earlhumdev.2015.08.006
M3 - Article
C2 - 26364515
AN - SCOPUS:84983158936
SN - 0378-3782
VL - 91
SP - 751
EP - 754
JO - Early Human Development
JF - Early Human Development
IS - 12
ER -