ABSTRACT
OBJECTIVE: To assess the neurodevelopmental functions of survivors of twin-twin transfusion syndrome (TTTS) treated by fetoscopic laser coagulation (FLC), during the first year of life, comparing them to a control group; and to verify the influence of specific variables on neurodevelopment. METHOD: This was a prospective, longitudinal study. The sample comprised 33 monochorionic diamniotic twins who underwent FLC for treatment of TTTS and 22 full-term infants of single-fetus pregnancies. Bayley Scales of Infant and Toddler Development Screening Test were used for evaluation. Prenatal, perinatal and postnatal information were obtained. RESULTS: There was an increased frequency of infants in the TTTS group with inadequate performance compared to the control group. The identified variables (fetal donor, low economic income and cardiorespiratory disease) negatively impacted expressive communication and fine motor skills. CONCLUSION: Although through follow-up is recommended in all TTTS survivors, particular attention is required for the high-risk group as defined in this study.
Subject(s)
Child Development/physiology , Fetofetal Transfusion/physiopathology , Fetofetal Transfusion/surgery , Fetoscopy/methods , Laser Coagulation/methods , Apgar Score , Case-Control Studies , Cerebral Palsy/etiology , Female , Fetofetal Transfusion/complications , Gestational Age , Humans , Infant , Infant, Newborn , Logistic Models , Longitudinal Studies , Male , Neurodevelopmental Disorders/etiology , Pregnancy , Prospective Studies , Risk Factors , Socioeconomic Factors , Treatment OutcomeABSTRACT
ABSTRACT Objective To assess the neurodevelopmental functions of survivors of twin-twin transfusion syndrome (TTTS) treated by fetoscopic laser coagulation (FLC), during the first year of life, comparing them to a control group; and to verify the influence of specific variables on neurodevelopment. Method This was a prospective, longitudinal study. The sample comprised 33 monochorionic diamniotic twins who underwent FLC for treatment of TTTS and 22 full-term infants of single-fetus pregnancies. Bayley Scales of Infant and Toddler Development Screening Test were used for evaluation. Prenatal, perinatal and postnatal information were obtained. Results There was an increased frequency of infants in the TTTS group with inadequate performance compared to the control group. The identified variables (fetal donor, low economic income and cardiorespiratory disease) negatively impacted expressive communication and fine motor skills. Conclusion Although through follow-up is recommended in all TTTS survivors, particular attention is required for the high-risk group as defined in this study.
RESUMO Objetivo Avaliar o desenvolvimento neurológico de sobreviventes da sindrome de transfusão feto-fetal (STFF) submetidos à coagulação a laser por fetoscopia (CLF), durante o primeiro ano de vida, comparando estes ao grupo controle; e verificar a influência de variáveis específicas no desenvolvimento. Método Tratou-se de estudo prospectivo, longitudinal. A amostra foi composta por 33 gêmeos diamnióticos monocoriônicos submetidos à CLF para tratamento da STFF e 22 lactentes a termo de gestação única. Bayley Scales of Infant and Toddler Development Screening Test foram utilizadas para avaliação. Informações pré-natal, perinatal e pós-natal foram coletadas. Resultados Houve maior número de lactentes com desempenho inadequado no grupo STFF do que no controle. As variáveis identificadas (feto doador, baixa renda econômica e doença cárdio-respiratória) influenciaram negativamente a comunicação expressiva e as habilidades motoras finas. Conclusão Embora o acompanhamento seja recomendado para todos lactentes com STFF, especial atenção deve ser dada àqueles que apresentam fatores de risco.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Male , Pregnancy , Child Development/physiology , Fetofetal Transfusion/physiopathology , Fetofetal Transfusion/surgery , Fetoscopy/methods , Laser Coagulation/methods , Apgar Score , Case-Control Studies , Cerebral Palsy/etiology , Fetofetal Transfusion/complications , Gestational Age , Logistic Models , Longitudinal Studies , Neurodevelopmental Disorders/etiology , Prospective Studies , Risk Factors , Socioeconomic Factors , Treatment OutcomeABSTRACT
PURPOSE: To compare the motor performance of infants born small for gestational age (SGA) with those appropriate for gestational age (AGA) at 1, 2, 3, and 6 months. METHODS: A prospective cross-sectional study was conducted including infants born full-term, with birth weight under the 10th percentile for the SGA group and between the 10th and 90th percentiles for the AGA group. The Motor Scale of Bayley Scales of Infant Development-II was used to document motor performance. RESULTS: The SGA group presented a mean motor index score lower than the AGA group at 2 and 6 months, with the SGA group presenting fewer infants that successfully accomplished "makes crawling movements," "turns from side to back," "balances head," "sits alone momentarily," and "sits alone for 30 seconds." CONCLUSIONS: Data analysis suggested that infants who are SGA present greater risk of adverse outcomes that are detectable in motor performance measures at 2 months.
