Authors’ reply to: Letter to the Editor in response to ‘Parental attachment and depressive symptoms in pregnancies complicated by twin‐twin transfusion syndrome: a cohort study’

We thank Rameh et al. [1] for highlighting the importance of our work [2]. The limitations of our study, as stated by Rameh et al. are mentioned in our published article. The need to interpret our findings of the post-ablation and postnatal questionnaires with caution due to the low numbers was highlighted in our article. We agree that future research should explore the additional potential associations with anxiety, coping styles in times of stress, the parent’s own attachment style, and romantic attachment to their partner on parental attachment. Ideally these associations should be explored with validated assessment tools. Interviews with parents would give additional useful information and may improve follow-up data collection. Additionally future studies should be performed in larger cohorts which would require collaboration between treatment centres. We hope that our study will improve patient care by increasing health care professional and patient awareness of the need to risk assess and screen mothers and fathers going through a pregnancy complicated by twin-twin transfusion syndrome for mental health problems, and consequently enabling additional psychological support where needed.