{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T21:10:56Z","timestamp":1788469856276,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T00:00:00Z","timestamp":1655683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effect of gestational age at laser therapy for twin\u2010to\u2010twin transfusion syndrome (TTTS) on perinatal outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and settings<\/jats:title>\n                    <jats:p>Single retrospective observational cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>All consecutive pregnancies affected by TTTS and referred to our department between January 2013 and August 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Gestational age was modelled both as a categorical and as a continuous variable. Log\u2010binomial regression was used to estimate the odds ratios (crude and adjusted for placental location, Quintero stage and cervical length) as well as the adjusted predicted probability of survival and fetal loss according to gestational age at laser therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes<\/jats:title>\n                    <jats:p>Fetal and neonatal survival, preterm prelabour rupture of membranes (PPROM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 503 pregnancies referred for TTTS, 431 were treated by laser therapy. Gestational age at laser therapy was positively and significantly associated with the overall survival at birth and at discharge (adjusted odds ratio [aOR] 1.12, 95% CI 1.05\u20131.19), as with a reduction in double fetal loss (aOR 0.81, 95% CI 0.71\u20130.92). Conversely, the rate of PPROM before 24\u2009weeks was significantly higher in early cases (32% of PPROM &lt;24\u2009weeks when laser therapy was performed before 17\u2009weeks versus 1.5% after 22\u2009weeks,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001, aOR 0.60, 95% CI 0.48\u20130.72). Among the survivors, preterm birth before 28\u2009weeks was significantly related to the gestational age at laser (OR 0.91, 95% CI 0.84\u20130.99), resulting in a significant impact on neonatal morbidity (OR 0.91, 95% CI 0.85\u20130.97).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our results suggest a significant and independent impact of the gestational age at laser surgery on perinatal survival, PPROM and neonatal morbidity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17228","type":"journal-article","created":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T07:54:48Z","timestamp":1653119688000},"page":"2028-2037","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Effect of gestational age at laser therapy on perinatal outcome in monochorionic diamniotic pregnancies affected by twin\u2010to\u2010twin transfusion syndrome"],"prefix":"10.1111","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8675-0846","authenticated-orcid":false,"given":"Raphael","family":"Bartin","sequence":"first","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital universitaire Necker\u2010Enfants malades  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Colmant","sequence":"additional","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital universitaire Necker\u2010Enfants malades  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bourgon","sequence":"additional","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital universitaire Necker\u2010Enfants malades  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Ville","sequence":"additional","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital universitaire Necker\u2010Enfants malades  Paris France"},{"name":"Facult\u00e9 de M\u00e9decine EA 7328 and PACT Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Stirnemann","sequence":"additional","affiliation":[{"name":"Obstetrics and Fetal Medicine H\u00f4pital universitaire Necker\u2010Enfants malades  Paris France"},{"name":"Facult\u00e9 de M\u00e9decine EA 7328 and PACT Universit\u00e9 de Paris  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000143828.41271.6c"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.050"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.14162"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2005.12.003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200292"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032597"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","unstructured":"RobertsD NeilsonJP KilbyMD GatesS.Interventions for the treatment of twin\u2010twin transfusion syndrome. 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