{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T23:56:38Z","timestamp":1790553398106,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007442","name":"Gratama Stichting","doi-asserted-by":"publisher","award":["2023\u201010\/W233029\u20102GSL"],"award-info":[{"award-number":["2023\u201010\/W233029\u20102GSL"]}],"id":[{"id":"10.13039\/501100007442","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010316","name":"Janivo Stichting","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010316","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Monochorionic (MC) twins are at risk of acute exsanguination after single fetal demise (sFD) due to their shared placental circulation, which may result in sequelae for survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the prevalence of ante\u2010 and postnatal brain injury and long\u2010term neurodevelopmental impairment (NDI) in co\u2010twins after sFD. Secondary outcomes were the prevalence of termination of pregnancy (TOP), neonatal death (NND) and potential risk factors for brain injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search Strategy<\/jats:title>\n                    <jats:p>PubMed, Embase, Scopus and Web of Science were searched to identify relevant studies in October 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection Criteria<\/jats:title>\n                    <jats:p>Studies reporting MC twin pregnancies with spontaneous sFD. Studies with selective feticide, twin reversed arterial perfusion sequence, twin anaemia\u2013polycythaemia sequence, congenital anomalies, higher\u2010order multiple pregnancies, fetoscopic laser surgery and double fetal demise were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Collection and Analysis<\/jats:title>\n                    <jats:p>Systematic review and meta\u2010analysis were performed following the PRISMA and MOOSE guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>Thirteen studies involving 311 survivors after sFD were included. The prevalence of TOP, NND, brain injury and NDI was 3% (95% CI: 0%\u20137%), 6% (95% CI: 0%\u201316%), 27% (95% CI: 18%\u201337%), 6% (95% CI: 3%\u201311%), respectively. The median GA at birth in survivors with brain injury was 29\u2009weeks (IQR 27.7\u201334.1) compared to 36\u2009weeks (IQR: 32.3\u201337.0) in the overall group of survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Brain injury occurs in one in four survivors and is associated with lower GA at birth, suggesting a double\u2010hit injury due to a combination of exsanguination and (severe) prematurity. NDI occurs in one in 20 survivors, compared to two\u2010thirds of those with brain injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO number: CRD42024608912<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.70084","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T10:35:45Z","timestamp":1762943745000},"page":"570-578","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Brain Injury and Neurodevelopmental Outcome in Survivors After Spontaneous Single Fetal Demise in Monochorionic Twins: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1715-093X","authenticated-orcid":false,"given":"Mathies","family":"Rondagh","sequence":"first","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Willem\u2010Alexander Children's Hospital Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotte C. M.","family":"Zwinkels","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Willem\u2010Alexander Children's Hospital Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine M. M.","family":"van Klink","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Willem\u2010Alexander Children's Hospital Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda S.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Willem\u2010Alexander Children's Hospital Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylke J.","family":"Steggerda","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Willem\u2010Alexander Children's Hospital Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke","family":"Slaghekke","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. J. T. (Joanne)","family":"Verweij","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0443-1997","authenticated-orcid":false,"given":"Monique C.","family":"Haak","sequence":"additional","affiliation":[{"name":"Division of Fetal Medicine, Department of Obstetrics Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8832-045X","authenticated-orcid":false,"given":"Sophie G.","family":"Groene","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Willem\u2010Alexander Children's Hospital Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Lopriore","sequence":"additional","affiliation":[{"name":"Division of Neonatology, Department of Pediatrics, Willem\u2010Alexander Children's Hospital Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001703\u2010200304000\u201000013"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8101711"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14722"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000500774"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/thg.2018.57"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2006.01027.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31822f129d"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.15530"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12237211"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2014.28"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.29242"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0166\u20104328(05)80189\u20105"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410250202"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27583"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000786"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239477"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3279"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1017\/thg.2015.49"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2018171267"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14604"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.4577"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.4274\/tjod.35493"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100412.2011.01239.x"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2009.07.002"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.06.062"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/14.8.2124"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mric.2024.03.004"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2017.11.017"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.7473"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2022.0483"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.83.2.f154"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000209264"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2011.12.006"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.24876"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/pd.49"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.14338"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471\u20100528.2007.01659.x"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1159\/000320783"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7475"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.18055"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2022.08.009"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.16291"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2023.10.007"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.3791\/3208"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70084","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.70084","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.70084","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T23:47:19Z","timestamp":1790552839000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.70084"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,12]]},"references-count":47,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/1471-0528.70084"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.70084","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,12]]},"assertion":[{"value":"2025-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}