Long-term follow-up of infants after transcervical chorionic villus sampling and after amniocentesis to compare congenital abnormalities and health status.
OBJECTIVE
Next to procedure-related fetal loss, other adverse effects of invasive prenatal diagnosis have been reported: limb defects after chorionic villus sampling (CVS) or early amniocentesis and respiratory distress after amniocentesis (AC). Because minor abnormalities may be overlooked in routine follow-up, we obtained long-term follow-up data after CVS and AC.


METHODS
1509 women with a singleton pregnancy who had transcervical CVS were matched by age and season of conception with 1509 women with singleton pregnancies who had AC. All procedures were performed during 1985-1991 for advanced maternal age >35 years. Data regarding congenital malformations (classified according Eurocat), neonatal and paediatric morbidity and complications of motor development, speech, hearing and visual function were obtained by questionnaire in 1993-1995.


RESULTS
Short-term outcome was known in all but ten infants. Questionnaires with a structured design were mailed to all women with a surviving infant (n=2810); 86.7% responded. No difference was detected between infants after CVS compared with infants after AC regarding congenital malformations (7.2% versus 6.3%), neonatal morbidity (15.1% versus 15.9%), paediatric morbidity with clinical treatment (7.7% versus 6.3%) or outpatient treatment only (43.9% versus 40.3%) and evident function disturbance (2.0% versus 2.0%) or doubtful function disturbance (6.3% versus 6.8%). The number of infants with physical growth <10th centile for Dutch infants was equal (10.1%). Sub-analysis for limb abnormalities or respiratory complications did not demonstrate differences between infants after CVS and AC. Only 10% of all congenital malformations were already known through routine post-partum follow-up.


CONCLUSIONS
An extensive long-term survey could not demonstrate differences of health status between infants after prenatal diagnosis by transcervical CVS and AC.
Department of Obstetrics and Gynaecology, Academic Medical Centre, University of Amsterdam, The Netherlands. A.H.Schapp@amc.uva.nl
Arty H P
AH
Schaap
Hans G
HG
van der Pol
Kees
K
Boer
Nico J
NJ
Leschot
Hans
H
Wolf
D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D015193:Chorionic Villi Sampling / Q000009:adverse effects*; D000013:Congenital Abnormalities / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011795:Surveys and Questionnaires