BACKGROUND Twin-twin transfusion syndrome (TTTS) is a highly morbid condition in which treatment exists, but the pregnancy remains high-risk until delivery. It may have serious sequelae, including fetal death, and in the longer term, neurodevelopmental problems. The aim of this study is to assess antenatal and postnatal parental attachment and depressive symptoms in those with pregnancies affected by TTTS. METHODS Couples attending for fetoscopic laser ablation treatment of TTTS were asked to complete Condon's Maternal/Paternal Antenatal/Postnatal Attachment Scale as appropriate, and the Edinburgh Depression Scale the day before ablation, 4 weeks post-ablation, and 6-10 weeks postnatally. RESULTS 25/27 couples completed the pre-ablation questionnaire (median gestational age 19 + 3 weeks [interquartile range 18 + 2-20 + 6]). 8/18 eligible couples returned the post-ablation questionnaire. 5/17 eligible couples returned the postnatal questionnaire. There was no significant difference in parento-fetal attachment when mothers were compared to fathers at each time point, however parento-fetal attachment did increase over time in mothers (p = 0.004), but not fathers. Mothers reported more depressive symptoms antenatally compared to fathers (p < 0.02), but there was no difference postnatally. 50% women reported Edinburgh Depression Scale scores above the cut-off (≥15) 4 weeks post-ablation. Over time maternal depressive symptoms decreased (p = 0.006), however paternal depressive symptoms remained the same. CONCLUSIONS This is the first attachment and depression study in a UK cohort of parents with pregnancies affected by TTTS. Although this was a small cohort and the questionnaires used had not been validated in these circumstances, the results suggest that centres caring for these couples should be aware of the risk of maternal and paternal antenatal depression, and screen and refer for additional psychological support. Further work is needed in larger cohorts. TRIAL REGISTRATION ISRCTN 13114861 (retrospectively registered).

中文翻译：

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妊娠并发双胎输血综合征的父母依恋和抑郁症状：一项队列研究。

背景技术双胞胎输血综合征（TTTS）是一种高度病态的疾病，存在治疗手段，但是直到分娩之前，怀孕仍然是高风险的。它可能有严重的后遗症，包括胎儿死亡，从长远来看，还会有神经发育问题。这项研究的目的是评估受TTTS影响的孕妇的产前和产后父母依恋和抑郁症状。方法要求参加夫妇的TTTS激光镜下消融治疗的夫妇，在完成消融前一天，消融后4周和产后6-10周时，分别填写Condon的孕产妇/父亲产前/产后依恋量表和爱丁堡抑郁量表。结果25/27对夫妇完成了消融前调查表（中位胎龄19 + 3周[四分位数范围18 + 2-20 + 6]）。8/18对符合条件的夫妇退还了消融后调查表。5/17对符合条件的夫妇退回了产后问卷。当在每个时间点将母亲与父亲进行比较时，父母与胎儿的依恋没有显着差异，但是母亲的父母与胎儿的依恋确实随时间增加（p = 0.004），但父亲没有。与父亲相比，母亲在产前有更多的抑郁症状（p <0.02），但产后无差异。50％的女性在消融后4周报告爱丁堡抑郁量表得分高于临界值（≥15）。随着时间的推移，产妇的抑郁症状有所减轻（p = 0.006），但是产妇的抑郁症状却保持不变。结论这是英国队列中TTTT影响的父母中的第一个依恋和抑郁研究。尽管这是一个很小的队列，并且在这种情况下未对所使用的问卷进行验证，但结果表明，照顾这些夫妇的中心应意识到孕产妇和父亲产前抑郁症的风险，并进行筛查并寻求其他心理支持。在较大的队列中还需要进一步的工作。试用注册ISRCTN 13114861（追溯注册）。