Early childhood neurodevelopmental outcome after open prenatal spina bifida aperta repair.
Zehra S Hepp, Verena M Haas, Beatrice Latal and 6 others
PMID 34296763WHAT IT FOUND
At 2 years, cognition was low-average at 95.15, still lower than the norm mean of 100.
Language and motor were also lower, with motor composite 77.78 and only 50.8% walking with or without devices.
Key findings
01The primary outcome, cognition composite score at 2 years, averaged 95.15, lower than the Bayley-III norm mean of 100.
02Motor composite score averaged 77.78, and gross motor scaled score averaged 3.02 against a norm mean of 10, while fine motor scaled score averaged 9.58 and was not lower than the norm.
03Language composite score averaged 89.83, lower than the norm mean of 100, and 30.8% scored below 85.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
There was no comparison group of children with postnatal spina bifida repair, so the study cannot show whether prenatal repair changed outcomes relative to postnatal repair. Neurodevelopmental assessments were not blinded because follow-up is part of routine clinical care. The analysed sample was smaller than the original surgical cohort: 77 children at 1 year and 65 at 2 years, after 10 were lost to follow-up and 21 had incomplete data. Outcomes were compared with population norms rather than a concurrently assessed control group. The cohort came from one centre and included families from Europe and Russia, so results may not apply to other populations.
The easy way to misread this
Do not read the low-average cognitive scores as evidence that prenatal repair produces better outcomes than postnatal repair. This cohort had no postnatal repair comparison, and language and motor scores were lower than population norms.