Early childhood neurodevelopmental outcome after open prenatal spina bifida aperta repair.

Autor: Hepp ZS; Division of Child Developmental Medicine, University Children's Hospital Zurich, Zurich, Switzerland., Haas VM; Division of Pediatric Neurology, University Children's Hospital Zurich, Zurich, Switzerland., Latal B; Division of Child Developmental Medicine, University Children's Hospital Zurich, Zurich, Switzerland.; Zurich Center for Spina Bifida, University Children's Hospital Zurich, Zurich, Switzerland., Meuli M; Zurich Center for Spina Bifida, University Children's Hospital Zurich, Zurich, Switzerland.; Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland.; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland., Möhrlen U; Zurich Center for Spina Bifida, University Children's Hospital Zurich, Zurich, Switzerland.; Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland.; The Zurich Center for Fetal Diagnosis and Therapy, Zurich, Switzerland., Schauer SM; Zurich Center for Spina Bifida, University Children's Hospital Zurich, Zurich, Switzerland.; Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland., Steinfeld R; Division of Pediatric Neurology, University Children's Hospital Zurich, Zurich, Switzerland., Padden BA; Zurich Center for Spina Bifida, University Children's Hospital Zurich, Zurich, Switzerland.; Division of Pediatric Rehabilitation, University Children's Hospital Zurich, Zurich, Switzerland., Wille DA; Zurich Center for Spina Bifida, University Children's Hospital Zurich, Zurich, Switzerland.; Department of Pediatric Neurology, Kantonsspital Baden, Baden, Switzerland.
Jazyk: angličtina
Zdroj: Developmental medicine and child neurology [Dev Med Child Neurol] 2021 Nov; Vol. 63 (11), pp. 1302-1307. Date of Electronic Publication: 2021 Jul 23.
DOI: 10.1111/dmcn.14993
Abstrakt: Aim: To investigate neurodevelopmental outcome of children with open prenatal spina bifida aperta (SBA) repair.
Method: Prenatal SBA repair was performed in 130 fetuses at the Zurich Center between 2010 and 2019. Seventy-seven children underwent 1 year assessment with the Griffiths Mental Developmental Scales (Griffiths) and 65 with the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) at 2 years. Anatomical and functional level and ambulation status were assessed. Descriptive statistics and multiple linear regression analyses for risk factors were performed.
Results: The Bayley-III cognition composite score in children with prenatal SBA repair was within normal limits but lower compared to population norms (mean=95.15, SD=14.683 vs norm=100, SD=15, p=0.01). Fine motor development (mean=9.58, SD=2.744, p=0.227) was typical while gross motor development was lower than the norm (mean=3.02, SD=2.758 vs norm=10, SD=3, p<0.001). Griffiths developmental quotient subscales correlated significantly with corresponding Bayley-III scores (all p<0.001, r=0.519-0.594). At 2 years, 50.8% could walk.
Interpretation: Children with non-trial open prenatal SBA repair show favourable cognitive outcome in the low-average range at 1 and 2 years of age. While gross motor function remained delayed, fine motor function was age appropriate. The correlation between Griffiths and Bayley-III allows a prediction about neurodevelopmental outcome at the age of 1 year. What this paper adds Children with non-trial open prenatal spina bifida repair show favourable cognitive outcome. Gross motor function remains impaired, while fine motor function is age appropriate. At 2 years of age, 50.8% of children were walking. Neurodevelopmental testing correlated between 1 (Griffiths Mental Developmental Scales) and 2 (Bayley Scales of Infant and Toddler Development, Third Edition) years.
(© 2021 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.)
Databáze: MEDLINE
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