Abstract: 【Abstract】 Objective To analyze the clinical characteristics of newborns with twin-twin transfusion syndrome (TTTS), and provide a clinical basis for the individualized management of TTTS newborns. Method A retrospective analysis was conducted on the clinical data of 92 pairs of TTTS newborns deliveredat the Third Affiliated Hospital of Guangzhou Medical University and transferred to the neonatal departmentfor treatment from January 2011 to December 2020. Among them, 67 pairs of live-born TTTS twins metthe study criteria. Using propensity score matching analysis, live-born twins without TTTS admitted to theneonatal department during the same period were selected for 1∶1 matching. Ultimately, 45 pairs (n=90)of TTTS twins were included in the TTTS group, and 45 pairs (n=90) of live-born twins were successfullymatched as the control group. The TTTS group was further stratified by disease severity, blood supply infant,and blood recipient infant. Differences in general characteristics and in-hospital mortality between the TTTSgroup and the control group were analyzed, as well as the incidence of complications in each systerm amongnewborns with varying degrees of TTTS severity, blood supply infant, and blood recipient infant. Statisticalmethods performed by independent samples t-test, χ2 test or Fisher exact probability method. Result Theincidence of TTTS in twin pregnancies was 1.9% (92/4 808). The incidence of TTTS group were significantlyhigher in neonatal asphyxia [32.2% (29/90) vs 14.4% (13/90), χ2=6.980, P=0.008], atrioventricular valveregurgitation [46.7% (42/90) vs 2.2% (2/90), χ2=45.752, P<0.001], neonatal respiratory distress syndrome[75.6% (68/90) vs 54.4% (49/90), χ2=7.912, P=0.005], bronchopulmonary dysplasia [28.9% (26/90) vs12.2% (11/90), χ2=6.668, P=0.010], severe brain injury [6.7% (6/90) vs 0 (0/90), P=0.029], retinopathy ofprematurity [37.8% (34/90) vs 8.8% (8/90), χ2=19.410, P<0.001], and in-hospital mortality [20.0% (18/90)vs 7.8% (7/90), χ2=4.645, P=0.031] than those of the control group, and the differences were statisticallysignificant. In the severe TTTS subgroup, the incidence of patent ductus arteriosus [28.0% (14/50) vs 7.9%(3/38), χ2=4.384, P=0.036] and neonatal respiratory distress syndrome [88.0% (44/50) vs 63.2% (24/38),χ2=6.238, P=0.013] were significantly higher than those in the mild TTTS subgroup, and the differences werestatistically significant. Conclusion TTTS newborns are at a relatively higher risk of complications suchas severe brain injury, neonatal asphyxia, in-hospital mortality, neonatal respiratory distress syndrome, and retinopathy of prematurity. The more severe the TTTS, the higher the risk of neonatal respiratory distress syndrome and patent ductus arteriosus in TTTS newborns.
2025, Vol. 13 
