title: [Does prenatal diagnosis modify neonatal management and early outcome of children with esophageal atresia type III?].
abstract: OBJECTIVE
  Evaluate neonatal management and outcome of neonates with either a prenatal or a post-natal diagnosis of EA type III.
  
  
  METHODS
  Population-based study using data from the French National Register for EA from 2008 to 2010. We compared children with prenatal versus post-natal diagnosis in regards to prenatal, maternal and neonatal characteristics. We define a composite variable of morbidity (anastomotic esophageal leaks, recurrent fistula, stenosis) and mortality at 1 year.
  
  
  RESULTS
  Four hundred and eight live births with EA type III were recorded with a prenatal diagnosis rate of 18.1%. Transfer after birth was lower in prenatal subset (32.4% versus 81.5%, P<0.001). Delay between birth and first intervention was not significantly different. Defect size (2cm vs 1.4cm, P<0.001), gastrostomy (21.6% versus 8.7%, P<0.001) and length in neonatal unit care were higher in prenatal subset (47.9 days versus 33.6 days, P<0.001). The composite variables were higher in prenatal diagnosis subset (38.7% vs 26.1%, P=0.044).
  
  
  CONCLUSIONS
  Despite the excellent survival rate of EA, cases with antenatal detection have a higher morbidity related to the EA type (longer gap). Even if it does not modify neonatal management and 1-year outcome, prenatal diagnosis allows antenatal parental counseling and avoids post-natal transfer.
authors.affiliation: Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France. Electronic address: charles.garabedian@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Garabedian
authors.affiliation: Centre de référence des anomalies congénitales et des maladies de l'œsophage (CRACMO), 59000 Lille, France.
authors.forename: R
authors.initials: R
authors.lastname: Sfeir
authors.affiliation: EA2694, UDSL, département de biostatistiques, université Lille Nord de France, CHRU de Lille, 59000 Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Langlois
authors.affiliation: Service de chirurgie pédiatrique, CHU Robert-Debré, 75019 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Bonnard
authors.affiliation: Service de chirurgie pédiatrique, CHU Necker-Enfant-Malades, 75015 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Khen-Dunlop
authors.affiliation: Service de chirurgie pédiatrique, CHU de Lyon, 69677 Lyon, France.
authors.forename: T
authors.initials: T
authors.lastname: Gelas
authors.affiliation: Centre de référence des anomalies congénitales et des maladies de l'œsophage (CRACMO), 59000 Lille, France.
authors.forename: L
authors.initials: L
authors.lastname: Michaud
authors.affiliation: Service de chirurgie pédiatrique, CHU Armand-Trousseau, 75571 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Auber
authors.affiliation: Service de chirurgie pédiatrique, CHU de Grenoble, 38000 Grenoble, France.
authors.forename: C
authors.initials: C
authors.lastname: Piolat
authors.affiliation: Service de chirurgie pédiatrique, CHU de Nancy, 54000 Nancy, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Lemelle
authors.affiliation: Service de chirurgie pédiatrique, CHU Kremlin-Bicêtre Paris, 94270 Kremlin-Bicêtre, France.
authors.forename: V
authors.initials: V
authors.lastname: Fouquet
authors.affiliation: Service de chirurgie pédiatrique, CHU de Rennes, 35000 Rennes, France.
authors.forename: É
authors.initials: É
authors.lastname: Habonima
authors.affiliation: Service de chirurgie pédiatrique, CHU de Strasbourg, 67000 Strasbourg, France.
authors.forename: F
authors.initials: F
authors.lastname: Becmeur
authors.affiliation: Service de chirurgie pédiatrique, CHU de Reims, 51100 Reims, France.
authors.forename: M-L
authors.initials: ML
authors.lastname: Polimerol
authors.affiliation: Service de chirurgie pédiatrique, CHU de Toulouse, 31000 Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Breton
authors.affiliation: Service de chirurgie pédiatrique, CHU de Caen, 14033 Caen, France.
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authors.lastname: Petit
authors.affiliation: Service de chirurgie pédiatrique, CHU de Nantes, 44000 Nantes, France.
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authors.lastname: Podevin
authors.affiliation: Service de chirurgie pédiatrique, CHU de Bordeaux, 33000 Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Lavrand
authors.affiliation: Service de chirurgie pédiatrique, CHU de Montpellier, 34000 Montpellier, France.
authors.forename: H
authors.initials: H
authors.lastname: Allal
authors.affiliation: Service de chirurgie pédiatrique, CHU de Saint-Étienne, 42055 Saint-Étienne, France.
authors.forename: M
authors.initials: M
authors.lastname: Lopez
authors.affiliation: Service de chirurgie pédiatrique, CHU de Rouen, 76000 Rouen, France.
authors.forename: F
authors.initials: F
authors.lastname: Elbaz
authors.affiliation: Service de chirurgie pédiatrique, CHU de Marseille Nord, 13015 Marseille, France.
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authors.lastname: Merrot
authors.affiliation: Service de chirurgie pédiatrique, CHU de La Reunion, 97400 Réunion.
authors.forename: J-L
authors.initials: JL
authors.lastname: Michel
authors.affiliation: Service de chirurgie pédiatrique, CHU d'Amiens, 80000 Amiens, France.
authors.forename: P
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authors.lastname: Buisson
authors.affiliation: Service de chirurgie pédiatrique, CHU de Dijon, 21079 Dijon, France.
authors.forename: E
authors.initials: E
authors.lastname: Sapin
authors.affiliation: Service de chirurgie pédiatrique, CHU de Marseille Timone, 13005 Marseille, France.
authors.forename: P
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authors.lastname: Delagausie
authors.affiliation: Service de chirurgie pédiatrique, centre hospitalier du Mans, 72037 Mans, France.
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authors.affiliation: Service de chirurgie pédiatrique, CHU de Poitiers, 86000 Poitiers, France.
authors.forename: J
authors.initials: J
authors.lastname: Gaudin
authors.affiliation: Service de chirurgie pédiatrique, CHU d'Angers, 49933 Angers, France.
authors.forename: D
authors.initials: D
authors.lastname: Weil
authors.affiliation: Service de chirurgie pédiatrique, CHU de Brest, 29200 Brest, France.
authors.forename: P
authors.initials: P
authors.lastname: de Vries
authors.affiliation: Service de chirurgie pédiatrique, CHU de Créteil, 94010 Créteil, France.
authors.forename: O
authors.initials: O
authors.lastname: Jaby
authors.affiliation: Service de chirurgie pédiatrique, CHU de Tours, 37000 Tours, France.
authors.forename: H
authors.initials: H
authors.lastname: Lardy
authors.affiliation: Service de pédiatrie, CHU de Besançon, 25000 Besançon, France.
authors.forename: D
authors.initials: D
authors.lastname: Aubert
authors.affiliation: Service de chirurgie pédiatrique, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
authors.forename: C
authors.initials: C
authors.lastname: Borderon
authors.affiliation: Service de chirurgie pédiatrique, CHU de Limoges, 87000 Limoges, France.
authors.forename: L
authors.initials: L
authors.lastname: Fourcade
authors.affiliation: Service de chirurgie pédiatrique, centre hospitalier de Colmar, 68000 Colmar, France.
authors.forename: S
authors.initials: S
authors.lastname: Geiss
authors.affiliation: Service de chirurgie pédiatrique, CHU de Nice, 06000 Nice, France.
authors.forename: J
authors.initials: J
authors.lastname: Breaud
authors.affiliation: Service de chirurgie pédiatrique, centre hospitalier d'Orléans, 45067 Orléans, France.
authors.forename: M
authors.initials: M
authors.lastname: Pouzac
authors.affiliation: Service de chirurgie pédiatrique, centre hospitalier de Fort de France, 97200 Fort-de-France, Martinique.
authors.forename: A
authors.initials: A
authors.lastname: Echaieb
authors.affiliation: Service de chirurgie pédiatrique, centre hospitalier de Point-à-Pître, 97159 Point-à-Pître, Guadeloupe.
authors.forename: C
authors.initials: C
authors.lastname: Laplace
authors.affiliation: Centre de référence des anomalies congénitales et des maladies de l'œsophage (CRACMO), 59000 Lille, France.
authors.forename: F
authors.initials: F
authors.lastname: Gottrand
authors.affiliation: Clinique d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France.
authors.forename: V
authors.initials: V
authors.lastname: Houfflin-Debarge
mesh_terms: D000367:Age Factors; D004933:Esophageal Atresia / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Associated malformations; Atrésie de l’œsophage; Diagnostic anténatal; Diagnostic post-natal; Esophageal atresia; Malformations associées; Post-natal diagnosis; Prenatal diagnosis; VACTERL