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Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence

  • Soo Jin Han , Seung Mi Lee , Sohee Oh , Subeen Hong , Jeong Won Oh , Seung Han Shin , Chan-Wook Park , Joong Shin Park and Jong Kwan Jun EMAIL logo
Published/Copyright: March 30, 2020
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 48 Issue 4

Abstract

Background

In monochorionic twin pregnancy, placental anastomosis and inter-twin blood transfusion can result in specific complications, such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). It is well established that adverse outcomes are increased in TTTS, but reports on the neonatal and long-term outcomes of TAPS are lacking. The objective of this study was to evaluate the neonatal and neurodevelopmental outcomes in spontaneous TAPS.

Methods

The study population consisted of monochorionic twin pregnancies with preterm birth (24–37 weeks of gestation) between November 2003 and December 2016 and in which cord blood was taken at the time of delivery. According to the result of hemoglobin in cord blood, the study population was divided into two groups: a spontaneous TAPS group and a control group. Neonatal and neurodevelopmental outcomes were compared between the two groups.

Results

During the study period, 11 cases were diagnosed as spontaneous TAPS (6.4%). The TAPS group had lower gestational age at delivery and had a higher risk for cesarean delivery. However, neonates with TAPS were not at an increased risk for neonatal mortality and significant neonatal morbidity. In addition, the frequency of severe cerebral lesion during the neonatal period and the risk of cerebral palsy at 2 years of age were not different between the two groups.

Conclusion

The spontaneous TAPS diagnosed by postnatal diagnostic criteria was not associated with the increased risk of adverse neonatal and neurodevelopmental outcomes. Further studies are needed to evaluate the morbidity of antenatally diagnosed TAPS.

Keywords: monochorionic twin pregnancy; neonatal morbidity; neurodevelopmental impairment; twin anemia-polycythemia sequence
Corresponding author: Jong Kwan Jun, MD, PhD, Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 110-744, Republic of Korea, Tel.: +82-2-2072-3744, Fax: 82-2-762-3599
aSoo Jin Han and Seung Mi Lee contributed equally to this work.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (funder ID: http://dx.doi.org/10.13039/501100003710, grant number: HI19C0213) and by a grant from the Seoul National University Hospital research fund (funder ID: http://dx.doi.org/10.13039/501100004332, grant number: 03-2019-0410).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2019-0437).

Received: 2019-11-26
Accepted: 2020-02-18
Published Online: 2020-03-30
Published in Print: 2020-04-28

©2020 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Women and children first: the need for ringfencing during the COVID-19 pandemic
  4. Review
  5. The decline of amniocentesis and the increase of chorionic villus sampling in modern perinatal medicine
  6. Original Articles – Obstetrics
  7. Fetal renal artery impedance in pregnancies affected by preeclampsia
  8. The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study
  9. Interpregnancy interval and the risk for recurrence of placental mediated pregnancy complications
  10. Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence
  11. How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?
  12. Disorders of placental villous maturation in fetal death
  13. Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes
  14. Appropriate delivery method for cardiac disease pregnancy based on noninvasive cardiac monitoring
  15. Original Articles – Fetus
  16. Success rate of five fetal cardiac views using HDlive Flow with spatiotemporal image correlation at 18–21 and 28–31 weeks of gestation
  17. Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls
  18. Can fetal fractions in the cell-free DNA test predict the onset of fetal growth restriction?
  19. Original Articles – Newborns
  20. Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g
  21. The contribution of twins conceived by in vitro fertilization to preterm birth rate: observations from a quarter of century
  22. Burnout in neonatal intensive care unit nurses: relationships with moral distress, adult attachment insecurities, and proneness to guilt and shame
https://doi.org/10.1515/jpm-2019-0437
Keywords for this article
monochorionic twin pregnancy; neonatal morbidity; neurodevelopmental impairment; twin anemia-polycythemia sequence

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Women and children first: the need for ringfencing during the COVID-19 pandemic
  4. Review
  5. The decline of amniocentesis and the increase of chorionic villus sampling in modern perinatal medicine
  6. Original Articles – Obstetrics
  7. Fetal renal artery impedance in pregnancies affected by preeclampsia
  8. The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study
  9. Interpregnancy interval and the risk for recurrence of placental mediated pregnancy complications
  10. Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence
  11. How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?
  12. Disorders of placental villous maturation in fetal death
  13. Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes
  14. Appropriate delivery method for cardiac disease pregnancy based on noninvasive cardiac monitoring
  15. Original Articles – Fetus
  16. Success rate of five fetal cardiac views using HDlive Flow with spatiotemporal image correlation at 18–21 and 28–31 weeks of gestation
  17. Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls
  18. Can fetal fractions in the cell-free DNA test predict the onset of fetal growth restriction?
  19. Original Articles – Newborns
  20. Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g
  21. The contribution of twins conceived by in vitro fertilization to preterm birth rate: observations from a quarter of century
  22. Burnout in neonatal intensive care unit nurses: relationships with moral distress, adult attachment insecurities, and proneness to guilt and shame
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