OC03.02: Neurodevelopmental outcomes after prenatal open neural tube defect repair

To compare neurodevelopmental (ND) outcomes in infants who had undergone prenatal open neural tube defect repair (ONTD) repair against infants who had a postnatal repair. 132 infants were included (prenatal repair: 93 [69 Fetoscopic/24 Open hysterotomy]; postnatal repair: 39). ND outcomes were evaluated by a developmental pediatrician using the Capute scales (CAT/CLAMS tests) and/or during parental interview using Developmental Profile 3 (DP-3) test. Scores were referenced against normative values for different ages and adjusted by prematurity. A “Delayed” score was defined when <70%. ND scores were compared while adjusting for infants' age at the time of testing and the need for hydrocephalus treatment. At 25 [18-42] months of age, there was a higher proportion of “delayed” CLAMS scores in the postnatal repair group (14/38[36.8%]) compared to the prenatal repair group (4/55[7.3%], p < 0.01) (see figure 1) and more “delayed” CAT scores in the postnatal repair group (14/39[35.9%]) compared to the prenatal repair group (5/54[9.3%], p = 0.03). Infants who underwent a Fetoscopic repair presented higher CAT scores (87.7[49-121]) compared to Open-hysterotomy repair group (80.5[44-112], p = 0.03). There were no other differences in the comparisons between both in utero repair approaches (see figure 1). Prenatally ONTD repaired infants showed better ND outcomes when compared against infants who had a postnatal repair. Fetoscopically repaired infants, had similar ND outcomes as those who had an open fetal surgery repair, except for higher visual and non-verbal problem-solving skills than their open-fetal surgery counterparts. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.