Early postnatal cardiac manifestations are associated with perinatal brain injury in preterm infants with twin to twin transfusion syndrome

Hannah Cho, Seung Han Shin, Jong Kwan Jun, Seung Hyun Shin, Yoo Jin Kim, Seh Hyun Kim, Ee Kyung Kim, Han Suk Kim

Research output: Contribution to journalArticle

Abstract

Altered hemodynamics associated with twin to twin transfusion syndrome (TTTS) can be manifested in the fetal and neonatal heart. This study evaluated the association between cardiac manifestations immediately after birth and brain injury in preterm infants with TTTS. Medical records of preterm infants who were born at <35 weeks of gestation with TTTS and admitted to the neonatal intensive care unit at Seoul National University Children’s Hospital between January 2011 and January 2018 were reviewed. TTTS was prenatally diagnosed and staged according to the Quintero criteria. Echocardiographic findings, brain ultrasound and MRI imaging findings were analyzed. Fifty-three infants were enrolled in this study. Thirty-two infants (60.3%) were treated by fetoscopic laser coagulation. Brain injury developed in 15 infants (28.3%). Hypotension within the first week and immediate postnatal cardiac manifestations were more prevalent in the brain injury group. In the multivariate analysis, acute kidney injury and cardiac manifestations, such as ventricular dysfunction and tricuspid regurgitation, were statistically associated with brain injury in the study population. Immediate postnatal cardiac manifestations, such as ventricular dysfunction and tricuspid regurgitation, can serve as surrogate markers for perinatal hemodynamic disturbance, which are associated with early neonatal brain injury in preterm infants with TTTS.

Original languageEnglish
Article number18505
JournalScientific Reports
Volume9
Issue number1
DOIs
StatePublished - 1 Dec 2019

Fingerprint

Fetofetal Transfusion
Premature Infants
Brain Injuries
Ventricular Dysfunction
Tricuspid Valve Insufficiency
Hemodynamics
Birth Injuries
Laser Coagulation
Fetal Heart
Neonatal Intensive Care Units
Acute Kidney Injury
Hypotension
Medical Records
Ultrasonography
Multivariate Analysis
Biomarkers
Pregnancy
Brain
Population

Cite this

@article{b31be1147bac40deb0d3c27a8d66b664,
title = "Early postnatal cardiac manifestations are associated with perinatal brain injury in preterm infants with twin to twin transfusion syndrome",
abstract = "Altered hemodynamics associated with twin to twin transfusion syndrome (TTTS) can be manifested in the fetal and neonatal heart. This study evaluated the association between cardiac manifestations immediately after birth and brain injury in preterm infants with TTTS. Medical records of preterm infants who were born at <35 weeks of gestation with TTTS and admitted to the neonatal intensive care unit at Seoul National University Children’s Hospital between January 2011 and January 2018 were reviewed. TTTS was prenatally diagnosed and staged according to the Quintero criteria. Echocardiographic findings, brain ultrasound and MRI imaging findings were analyzed. Fifty-three infants were enrolled in this study. Thirty-two infants (60.3{\%}) were treated by fetoscopic laser coagulation. Brain injury developed in 15 infants (28.3{\%}). Hypotension within the first week and immediate postnatal cardiac manifestations were more prevalent in the brain injury group. In the multivariate analysis, acute kidney injury and cardiac manifestations, such as ventricular dysfunction and tricuspid regurgitation, were statistically associated with brain injury in the study population. Immediate postnatal cardiac manifestations, such as ventricular dysfunction and tricuspid regurgitation, can serve as surrogate markers for perinatal hemodynamic disturbance, which are associated with early neonatal brain injury in preterm infants with TTTS.",
author = "Hannah Cho and Shin, {Seung Han} and Jun, {Jong Kwan} and Shin, {Seung Hyun} and Kim, {Yoo Jin} and Kim, {Seh Hyun} and Kim, {Ee Kyung} and Kim, {Han Suk}",
year = "2019",
month = "12",
day = "1",
doi = "10.1038/s41598-019-54951-z",
language = "English",
volume = "9",
journal = "Scientific reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",

}

Early postnatal cardiac manifestations are associated with perinatal brain injury in preterm infants with twin to twin transfusion syndrome. / Cho, Hannah; Shin, Seung Han; Jun, Jong Kwan; Shin, Seung Hyun; Kim, Yoo Jin; Kim, Seh Hyun; Kim, Ee Kyung; Kim, Han Suk.

In: Scientific Reports, Vol. 9, No. 1, 18505, 01.12.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Early postnatal cardiac manifestations are associated with perinatal brain injury in preterm infants with twin to twin transfusion syndrome

AU - Cho, Hannah

AU - Shin, Seung Han

AU - Jun, Jong Kwan

AU - Shin, Seung Hyun

AU - Kim, Yoo Jin

AU - Kim, Seh Hyun

AU - Kim, Ee Kyung

AU - Kim, Han Suk

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Altered hemodynamics associated with twin to twin transfusion syndrome (TTTS) can be manifested in the fetal and neonatal heart. This study evaluated the association between cardiac manifestations immediately after birth and brain injury in preterm infants with TTTS. Medical records of preterm infants who were born at <35 weeks of gestation with TTTS and admitted to the neonatal intensive care unit at Seoul National University Children’s Hospital between January 2011 and January 2018 were reviewed. TTTS was prenatally diagnosed and staged according to the Quintero criteria. Echocardiographic findings, brain ultrasound and MRI imaging findings were analyzed. Fifty-three infants were enrolled in this study. Thirty-two infants (60.3%) were treated by fetoscopic laser coagulation. Brain injury developed in 15 infants (28.3%). Hypotension within the first week and immediate postnatal cardiac manifestations were more prevalent in the brain injury group. In the multivariate analysis, acute kidney injury and cardiac manifestations, such as ventricular dysfunction and tricuspid regurgitation, were statistically associated with brain injury in the study population. Immediate postnatal cardiac manifestations, such as ventricular dysfunction and tricuspid regurgitation, can serve as surrogate markers for perinatal hemodynamic disturbance, which are associated with early neonatal brain injury in preterm infants with TTTS.

AB - Altered hemodynamics associated with twin to twin transfusion syndrome (TTTS) can be manifested in the fetal and neonatal heart. This study evaluated the association between cardiac manifestations immediately after birth and brain injury in preterm infants with TTTS. Medical records of preterm infants who were born at <35 weeks of gestation with TTTS and admitted to the neonatal intensive care unit at Seoul National University Children’s Hospital between January 2011 and January 2018 were reviewed. TTTS was prenatally diagnosed and staged according to the Quintero criteria. Echocardiographic findings, brain ultrasound and MRI imaging findings were analyzed. Fifty-three infants were enrolled in this study. Thirty-two infants (60.3%) were treated by fetoscopic laser coagulation. Brain injury developed in 15 infants (28.3%). Hypotension within the first week and immediate postnatal cardiac manifestations were more prevalent in the brain injury group. In the multivariate analysis, acute kidney injury and cardiac manifestations, such as ventricular dysfunction and tricuspid regurgitation, were statistically associated with brain injury in the study population. Immediate postnatal cardiac manifestations, such as ventricular dysfunction and tricuspid regurgitation, can serve as surrogate markers for perinatal hemodynamic disturbance, which are associated with early neonatal brain injury in preterm infants with TTTS.

UR - http://www.scopus.com/inward/record.url?scp=85076315264&partnerID=8YFLogxK

U2 - 10.1038/s41598-019-54951-z

DO - 10.1038/s41598-019-54951-z

M3 - Article

C2 - 31811241

AN - SCOPUS:85076315264

VL - 9

JO - Scientific reports

JF - Scientific reports

SN - 2045-2322

IS - 1

M1 - 18505

ER -