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Prognostic risk factors for early outcomes of patients with myelomeningocele: a prospective study.

Authors :
Naseri Alavi SA
Rezkhah A
Majdi A
Habibi MA
Bagheri MM
Jafarzadeh F
Kobets AJ
Source :
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2024 Sep; Vol. 40 (9), pp. 2859-2863. Date of Electronic Publication: 2024 Jun 07.
Publication Year :
2024

Abstract

Introduction: Myelomeningocele (MMC) is a prevalent form of neural tube defect. Despite advancements in treatment, MMC still poses significant health risks, including complications leading to chronic disability and mortality. Identifying prognostic risk factors for early outcomes is crucial for tailored intervention strategies.<br />Methods: This prospective study involved newborns and infants diagnosed with MMC who underwent surgery between 2020 and 2023 at Urmia University of Medical Sciences. Demographic data and surgical outcomes were collected, and participants were followed up for six months. Statistical analyses were conducted using descriptive statistics, Chi-Square, and independent t-test.<br />Results: The study included 29 MMC cases, with an incidence rate of 1.4 per 10,000 live births. Lesions were predominantly located in the lumbar spine. Although mortality rates appeared to increase with ascending lesion sites, this trend was not statistically significant. Short-term outcomes revealed high morbidity and mortality rates, with neurological deficits being the most prevalent complication. Multivariable analysis identified head circumference as a significant predictor of adverse outcomes (IRR = 1.37, 95% CI = 1.02 to 1.86, p = 0.04). Furthermore, an increase in birth weight was associated with a reduction in the incidence of requiring a ventriculoperitoneal shunt (IRR = 0.99, 95% CI = 0.998 to 0.999, p = 0.02).<br />Conclusion: This prospective study highlights prognostic risk factors for early outcomes in MMC patients, emphasizing the need for personalized intervention strategies. By addressing modifiable risk factors and implementing targeted interventions, healthcare providers can strive to improve outcomes and enhance the quality of life for MMC patients.<br /> (© 2024. The Author(s).)

Details

Language :
English
ISSN :
1433-0350
Volume :
40
Issue :
9
Database :
MEDLINE
Journal :
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
Publication Type :
Academic Journal
Accession number :
38847879
Full Text :
https://doi.org/10.1007/s00381-024-06455-z