title: Open spina bifida: birth findings predict long-term outcome.
abstract: OBJECTIVE
  To investigate if lifestyle in spina bifida at age 40±3 years, relates to neurological deficit in infancy or cerebrospinal fluid shunt history.
  
  
  METHODS
  Prospective cohort study with 100% ascertainment.
  
  
  METHODS
  Community.
  
  
  METHODS
  117 consecutive cases of open spina bifida whose backs were closed non-selectively at birth. In 2007, all 46 (39%) survivors and/or carers were surveyed by postal questionnaires and telephone interviews.
  
  
  RESULTS
  Of the 38 children with absent sensation only below the knee (sensory level below L3), 23 (61%) survived of whom 14 (61%) were community walkers and only 5 (22%) needed daily care. But in 42 babies with absent sensation up to the umbilicus (sensory level above T11) only seven (17%) survived, none could walk and five (71%) needed daily care. Survivors with no shunt revisions were more likely to walk, live independently and drive a car.
  
  
  CONCLUSIONS
  Mobility and the need for care at 40 can be predicted from the neurological deficit.
authors: Population Health Sciences and Education, St George's University of London, Cranmer Terrace, London UK. p.oakeshott@sgul.ac.uk
authors: Pippa
authors: P
authors: Oakeshott
authors: Gillian M
authors: GM
authors: Hunt
authors: Alison
authors: A
authors: Poulton
authors: Fiona
authors: F
authors: Reid
mesh_terms: D000203:Activities of Daily Living; D002557:Cerebrospinal Fluid Shunts; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008019:Life Style; D008297:Male; D011379:Prognosis; D012678:Sensation Disorders / Q000209:etiology; D012720:Severity of Illness Index; D016137:Spina Bifida Cystica / Q000150:complications / Q000534:rehabilitation* / Q000601:surgery; D016896:Treatment Outcome