Comparing characteristics and outcomes in infants with prenatal and postnatal diagnosis of esophageal atresia.
BACKGROUND
Previous studies of infants with esophageal atresia (EA) suggest those diagnosed prenatally have worse outcomes because of a higher incidence of associated anomalies. The purpose of this study was to compare characteristics and outcomes of infants with EA diagnosed after fetal center evaluation to those diagnosed postnatally.


METHODS
The records of all neonates treated for EA at our institution from 2002-2012 were reviewed. Infants with a prenatal diagnosis of EA were compared with those postnatally diagnosed using chi-square and Student t-test as appropriate.


RESULTS
Of 91 patients treated with EA during the study period, 15 (16%) were diagnosed prenatally at our fetal center. Although those prenatally diagnosed had a higher incidence of pure EA and polyhydramnios, the gestational age and birth weight in that group were similar to those diagnosed postnatally. There were no differences in outcomes between groups with regard to the incidence of major cardiac anomalies, surgical complications, hospital length of stay, and survival.


CONCLUSIONS
Treatment at a tertiary care center provides excellent outcomes for all infants with EA, despite an 80% frequency of concurrent anomalies. Prenatal diagnosis of EA and attentive obstetric management of polyhydramnios decrease the risk for prematurity and prematurity-associated morbidity.
Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Sara C
SC
Fallon
Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Cecilia G
CG
Ethun
Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
Oluyinka O
OO
Olutoye
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Mary L
ML
Brandt
Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Timothy C
TC
Lee
Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas; Division of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
Stephen E
SE
Welty
Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
Rodrigo
R
Ruano
Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas. Electronic address: dcass@bcm.edu.
Darrell L
DL
Cass
D004933:Esophageal Atresia / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis
Esophageal atresia; Fetal MRI; Fetal center; Prenatal diagnosis; Tracheoesophageal fistula