Introduction: Despite improved perinatal survival following fetoscopic laser coagulation (FLC) for twin twin transfusion syndrome (TTTS), monochorionic diamniotic twin pregnancies complicated by TTTS have poorer perinatal outcome as compared with uncomplicated monochorionic diamniotic pregnancies. Understanding the risk factors for neurological development is a major concern of clinical research.

Objective: To assess the neurodevelopmental functions of survivors of TTTS treated by FLC and to verify the influence of risk factors on neurodevelopment.

Methods: This was a prospective and longitudinal study. The sample comprised 29 monochorionic diamniotic twins who underwent FLC for treatment of TTTS. Bayley Scales of Infant and Toddler Development Screening Tests were used. The infants were assessed twice, first evaluation (1 to 6 months) and second evaluation (7 to 12 months). Prenatal, perinatal and postnatal information were obtained.

Results: Inappropriate performance in both evaluations was around 20.7% (cognitive domain), 10.3% (receptive communication), 24.1% (expressive communication), 27.6% (fine motor) and 27.6% (gross motor). In multivariate analysis, infants whose mothers had lower parity and higher gestational age at surgery showed higher risk of cognitive disturbances. Moreover infants whose families had lower economic income and infants classified as donors showed higher risk of expressive communication disturbance.

Discussion/Conclusion: Although most of the children had adequate development what is in favor of a good intrauterine treatment (FLC), the identified risk factors (maternal parity, gestational age, economic income and fetal donor) negatively impacted cognitive and expressive communication; therefore, these children require monitoring for neurodevelopmental achievement.