{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T09:36:51Z","timestamp":1771580211570,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2015,7,6]],"date-time":"2015-07-06T00:00:00Z","timestamp":1436140800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Willem Alexander Kinderfonds"},{"name":"Leiden University Medical Centre"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the incidence of and risk factors for adverse long\u2010term neurodevelopmental outcome in complicated monochorionic pregnancies treated with selective feticide at our centre between 2000 and 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>National referral centre for fetal therapy (Leiden University Medical Centre, the Netherlands).<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Neurodevelopmental outcome was assessed in 74 long\u2010term survivors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children, at least 2\u00a0years of age, underwent an assessment of neurologic, motor and cognitive development using standardised psychometric tests and the parents completed a behavioural questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>A composite outcome termed neurodevelopmental impairment including cerebral palsy (<jats:styled-content style=\"fixed-case\">GMFCS II<\/jats:styled-content>\u2010V), cognitive and\/or motor test score of &lt;70, bilateral blindness or bilateral deafness requiring amplification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 131 monochorionic pregnancies were treated with selective feticide at the Leiden University Medical Centre. Overall survival rate was 88\/131 (67%). Long\u2010term outcome was assessed in 74\/88 (84%). Neurodevelopmental impairment was detected in 5\/74 [6.8%, 95%\u00a0confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), 1.1\u201312.5] of\u00a0survivors. Overall adverse outcome, including perinatal mortality or neurodevelopmental impairment was 48\/131 (36.6%). In multivariate analysis, parental educational level was\u00a0associated with cognitive test scores (regression coefficient B 3.9, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.8\u20136.0). Behavioural problems were reported in 10\/69 (14.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adverse long\u2010term outcome in survivor twins of complicated monochorionic pregnancies treated with selective feticide appears to be more prevalent than in the general population. Cognitive test scores were associated with parental educational level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Neurodevelopmental impairment after selective feticide was detected in 5\/74 (6.8%, 95% CI 1.1\u201312.5) of survivors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13490","type":"journal-article","created":{"date-parts":[[2015,7,6]],"date-time":"2015-07-06T06:30:18Z","timestamp":1436164218000},"page":"1517-1524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Long\u2010term neurodevelopmental outcome after selective feticide in monochorionic pregnancies"],"prefix":"10.1111","volume":"122","author":[{"given":"JMM","family":"van Klink","sequence":"first","affiliation":[{"name":"Division of Neonatology Department of Paediatrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HM","family":"Koopman","sequence":"additional","affiliation":[{"name":"Clinical Psychology Faculty of Social Sciences Leiden University Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JM","family":"Middeldorp","sequence":"additional","affiliation":[{"name":"Division of Fetal Therapy Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"FJ","family":"Klumper","sequence":"additional","affiliation":[{"name":"Division of Fetal Therapy Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Rijken","sequence":"additional","affiliation":[{"name":"Division of Neonatology Department of Paediatrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Oepkes","sequence":"additional","affiliation":[{"name":"Division of Fetal Therapy Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Lopriore","sequence":"additional","affiliation":[{"name":"Division of Neonatology Department of Paediatrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-3552(87)80012-3"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14722"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822f129d"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2013.12.007"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1515\/JPM.1999.046"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.08.039"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.07.043"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.2025"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1002\/uog.11122","article-title":"Radiofrequency ablation vs bipolar umbilical cord coagulation in the management of complicated monochorionic pregnancies","volume":"40","author":"Bebbington MW","year":"2012","journal-title":"Ultrasound Obstet Gynecol"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.11073"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00746.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.09.013"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gyobfe.2012.12.007"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.12408"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197801000-00001"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0166-4328(05)80189-5"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.56.12.900"},{"key":"e_1_2_6_20_1","unstructured":"Sociaal Cultureel Planbureau. 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