Fetal and neonatal outcomes in planned versus unplanned pregnancies in people with spina bifida

Introduction There is limited information on the impact of pregnancy planning on neonatal outcomes in people with spina bifida (SB). Methods This study is a sub-group analysis of The Spina Bifida Reproductive Health and Pregnancy Study, an online international cross-sectional survey. Pregnancy, birth and neonatal data were assessed using descriptive and chi-squared analyses. Results A total of 209 pregnancies were included: 108 planned and 101 unplanned. The unplanned group included a greater risk of miscarriage/ectopic pregnancy (30%), unplanned fetal loss (34%), intrauterine growth restriction less than 5th percentile (16%) and babies with congenital anomalies. There was no statistically significant difference between unplanned and planned pregnancies in terms of admission to neonatal intensive care unit or risk of preterm birth. Conclusion People with SB have rates of unplanned pregnancy similar to the general population. Unplanned pregnancies appear to have increased fetal and neonatal risks. Findings suggest that pregnancy planning is a modifiable factor, which may improve outcomes.