4.2 Article

Child Temperament Outcomes After Laser Surgery for Twin-Twin Transfusion Syndrome

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/DBP.0000000000000851

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identical twins; monozygotic twins; twin-twin transfusion syndrome; child temperament; epigenetics

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  1. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California

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The study found no significant temperament differences between twins treated in utero for TTTS, despite the different in utero environments they experienced. This may provide some reassurance to parents whose pregnancies are complicated by TTTS.
Objective: Twin-twin transfusion syndrome (TTTS) is a severe pregnancy complication of monochorionic (identical) twins that results in markedly discordant in utero environments for each twin. The aim of this study was to test for differences in temperament between former donor (hypovolemic, smaller) and recipient (hypervolemic, larger) twins with TTTS. Methods: Parents of dual survivors aged 3 to 7 years who underwent in utero laser surgery for TTTS were surveyed using the Children's Behavior Questionnaire-Very Short Form (CBQ-VSF). The CBQ-VSF assessed 3 traits: Surgency, Negative Affect, and Effortful Control. Differences in traits between donor and recipients were assessed using a paired t test. Results: We studied 85 twin pairs treated in utero for TTTS. There were no statistically significant differences in Surgency, Negative Affect, or Effortful Control between recipients and donors, although score differences for each trait varied widely among sibling pairs. Conclusion: Despite varied in utero environments, no temperament differences between donor and recipient monozygotic twins were found for the population as a whole. This finding may be of some reassurance to parents whose pregnancies are complicated by TTTS.

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