We read with interest the thought provoking paper written by Dr.
Bodeau-Livinecr and colleagues on behalf of the EPIPAGE. They concluded
that compared with very preterm singletons, twins had higher mortality, no
difference in severe deficiencies, but slightly lower Mental Processing
Composite scores at 5 years. 1
The Authors suggest that although all the infants studied who were
born preterm had been exposed to a pregnancy complication that had led to
their early birth, these may not be the same (i.e. in utero death of the
co-twin, being born second, monochorionic placenta, and birthweight
discordance) and may not have the same neurodevelopmental consequences in
singletons and twins. 1
Accumulating evidence indicates that the prenatal environment plays a
significant role in shaping children's neurodevelopment. Some authors
hypothesize that prenatal psychological distress on the part of the mother
is a risk factor for children's neurocognitive development. 2 We have been
assessing subjective states in singleton and twin pregnant women using
L?scher's 8-color test. 3 According to test results, singleton and twin
pregnant women share feelings denoting a particular emotional state,
idealizing their status, although perceiving it as stressful. Twin
pregnant women are afraid of building a relationship with their infants
and those women who became pregnant with twins following assisted
reproduction technologies perceive their pregnancy as exhausting,
characterized by a deep-seated anxious state and by the wish to give
birth soon. This is a particularly complex situation in which mothers are
at risk for anxiety, depression, and unsatisfactory postnatal bonding.
Studies specifically including maternal psychological distress in
their design will be able to assess the relative and/or synergistic impact
of these prenatal experiences on developmental trajectories. Once again,
we would like to thank the Authors for bringing these considerations to
the forefront and hope to read other articles on this timely subject.
References
1. Bodeau-Livinec F, Zeitlin J, et al. Do very preterm twins and
singletons differ in their neurodevelopment at 5 years of age? Arch Dis
Child Fetal Neonatal Ed. 2013 Jul 17.
2. Monk C, Georgieff MK, Osterholm EA. Research review: maternal
prenatal distress and poor nutrition - mutually influencing risk factors
affecting infant neurocognitive development. J Child Psychol Psychiatry
2013;54:115-30.
3. L?scher, M. The L?scher Colour Test. Translated and edited by
Ian. A. Scott. London: Pan Books, 1972.
Conflict of Interest:
None declared
We read with interest the thought provoking paper written by Dr. Bodeau-Livinecr and colleagues on behalf of the EPIPAGE. They concluded that compared with very preterm singletons, twins had higher mortality, no difference in severe deficiencies, but slightly lower Mental Processing Composite scores at 5 years. 1
The Authors suggest that although all the infants studied who were born preterm had been exposed to a pregnancy complication that had led to their early birth, these may not be the same (i.e. in utero death of the co-twin, being born second, monochorionic placenta, and birthweight discordance) and may not have the same neurodevelopmental consequences in singletons and twins. 1
Accumulating evidence indicates that the prenatal environment plays a significant role in shaping children's neurodevelopment. Some authors hypothesize that prenatal psychological distress on the part of the mother is a risk factor for children's neurocognitive development. 2 We have been assessing subjective states in singleton and twin pregnant women using L?scher's 8-color test. 3 According to test results, singleton and twin pregnant women share feelings denoting a particular emotional state, idealizing their status, although perceiving it as stressful. Twin pregnant women are afraid of building a relationship with their infants and those women who became pregnant with twins following assisted reproduction technologies perceive their pregnancy as exhausting, characterized by a deep-seated anxious state and by the wish to give birth soon. This is a particularly complex situation in which mothers are at risk for anxiety, depression, and unsatisfactory postnatal bonding.
Studies specifically including maternal psychological distress in their design will be able to assess the relative and/or synergistic impact of these prenatal experiences on developmental trajectories. Once again, we would like to thank the Authors for bringing these considerations to the forefront and hope to read other articles on this timely subject.
References
1. Bodeau-Livinec F, Zeitlin J, et al. Do very preterm twins and singletons differ in their neurodevelopment at 5 years of age? Arch Dis Child Fetal Neonatal Ed. 2013 Jul 17.
2. Monk C, Georgieff MK, Osterholm EA. Research review: maternal prenatal distress and poor nutrition - mutually influencing risk factors affecting infant neurocognitive development. J Child Psychol Psychiatry 2013;54:115-30.
3. L?scher, M. The L?scher Colour Test. Translated and edited by Ian. A. Scott. London: Pan Books, 1972.
Conflict of Interest:
None declared