title: Role of prenatal ultrasound in predicting survival and mental and motor functioning in children with spina bifida.
abstract: OBJECTIVE
  To determine which prenatal ultrasound findings can predict survival and mental and motor functioning in children with spina bifida.
  
  
  METHODS
  Prenatal ultrasound examinations of all liveborn children who were prenatally diagnosed with spina bifida between 1997 and 2002 at the University Medical Centre, Utrecht (n = 41) were retrospectively reviewed for lesion level, head circumference, ventriculomegaly, scoliosis and talipes. These measures were correlated with postnatal anatomical (as assessed by magnetic resonance imaging (MRI)) and functional lesion levels, survival and motor and mental outcome at 5 years of age. The capacity of prenatal ultrasonography to determine lesion level was also assessed in all fetuses diagnosed with spina bifida from 2006-2007 (n = 18).
  
  
  RESULTS
  Nineteen infants died before the age of 5 years. Multivariate regression analysis showed that higher lesion level and head circumference > or = the 90th percentile on prenatal ultrasound examination were independent predictors of demise (P < 0.05 and P = 0.01, respectively). None of the ultrasound features was a predictor of motor or mental functioning. Ultrasound predicted anatomical lesion level within one level of the postnatal findings in 50% of the first cohort and 89% of the second cohort (P < 0.01). The level of the anatomical lesion as assessed by postnatal MRI differed from the functional lesion by as many as six vertebral levels.
  
  
  CONCLUSIONS
  Lesion level and head circumference on prenatal ultrasound are predictive of survival in children with spina bifida. No predictors were found for mental or motor function at the age of 5 years.
authors: Department of Neurology and Neurosurgery, University Medical Centre Utrecht, Utrecht 3508 AB, The Netherlands.
authors: S
authors: S
authors: Van Der Vossen
authors: L R
authors: LR
authors: Pistorius
authors: E J H
authors: EJ
authors: Mulder
authors: M
authors: M
authors: Platenkamp
authors: P
authors: P
authors: Stoutenbeek
authors: G H A
authors: GH
authors: Visser
authors: R H J M
authors: RH
authors: Gooskens
mesh_terms: D002675:Child, Preschool; D002658:Developmental Disabilities / Q000000981:diagnostic imaging; D005260:Female; D005865:Gestational Age; D006257:Head / Q000000981:diagnostic imaging* / Q000254:growth & development; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011379:Prognosis; D011597:Psychomotor Performance / Q000502:physiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D016135:Spinal Dysraphism / Q000000981:diagnostic imaging* / Q000196:embryology / Q000401:mortality; D016019:Survival Analysis; D016216:Ultrasonography, Prenatal