Prenatal repair of myelomeningocele is associated with lower need for long-term feeding support.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-07-23 DOI:10.1038/s41372-025-02356-4

Jennifer Healy, Chunyan Liu, Shelley Ehrlich, Foong-Yen Lim, Jose L Peiro, Beth Haberman, Charles B Stevenson, Stefanie Riddle

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引用次数: 0

Abstract

Objective: Infants with myelomeningocele (MMC) are at risk of brainstem dysfunction secondary to symptomatic Chiari II malformation with hindbrain herniation (HH), which can manifest as feeding difficulties including aspiration and dysphagia. This study aims to investigate whether prenatal repair of MMC is associated with improved feeding outcomes compared to postnatal repair.

Study design: Retrospective observational study of 208 infants with MMC, 105 repaired prenatally and 103 repaired postnatally, from January 2011 to July 2022. Primary outcome was feeding tube at discharge and longitudinally through 12 months corrected gestational age (CGA).

Results: 9.5% of infants repaired prenatally and 13.6% repaired postnatally required feeding tube at discharge (p = 0.3585). By 53 weeks CGA, the prenatal repair group had decreased odds of requiring feeding tube (0.325 [95% CI 0.121, 0.872]).

Conclusion: Prenatal MMC repair was associated with decreased need for long-term feeding support, suggesting a potential functional benefit of prenatal repair related to reversal of HH.

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脊髓脊膜膨出的产前修复与较低的长期喂养支持需求相关。

目的：脊髓脊膜膨出（MMC）婴儿有继发于症状性Chiari II型畸形并后脑疝（HH）的脑干功能障碍的风险，其表现为吸入和吞咽困难等喂养困难。本研究旨在探讨与产后修复相比，产前修复MMC是否与改善喂养结果相关。研究设计：2011年1月至2022年7月，回顾性观察研究208例MMC患儿，105例产前修复，103例产后修复。主要结局是出院时的饲管和12个月矫正胎龄（CGA）。结果：9.5%的婴儿在产前修复，13.6%的婴儿在产后出院时修复了所需的饲管（p = 0.3585）。在CGA 53周时，产前修复组需要饲管的几率降低（0.325 [95% CI 0.121, 0.872]）。结论：产前MMC修复与减少对长期喂养支持的需求相关，提示产前修复与逆转HH相关的潜在功能益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.