Margareta dahl lecture

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NNFM Nordic Network of Fetal Medicine

Margareta Dahl, NNFM Nordic Network of Fetal Medicine meeting in Gothenburg 14-16th of April 2015.

Healthcare

A cohort of children with
myelomeningocele, born 2007- 2014:
Clinical characteristics
Dahl M, Månsson E, Westbom L
Universities of Uppsala, Örebro and Lund, Sweden

Decreased incidence
at birth
MYELOMENINGOCELE
Increased survival
rate into adulthood

MMCUP
Swedish National Quality Care Registry
Internet-based secondary
prevention follow up
Spina Bifida and
Hydrocephalus

AIMS OF THE STUDY
Children with MMC, born 2007-2014
1. Clinical characteristics?
2. Different from children with MMC,
born 1988 - 1991?

STUDY GROUP (23 children)
All children with MMC:
* Born 2007-2014
* Uppsala/Örebro region
* Surgical closure
Medical records

MMC born 2007-2014 (n = 23)
Boys 13 (56 %)
Prematurity 5 (22 %)
Sectio 20 (87 %)
Asphyxia 5 (22 %)
Thoracal cele 9 (39 %)

MMC born 2007-2014 (n = 23)
Shunt 19 (83 %)
Severe spinal deform 10 (43 %)
Brainstem symptoms 8 (35 %)
Ad mortem < 1 mo 3 (13 %)
Ad mortem < 3 mo 4 (17 %)

MMC born 2007-2014:
Socio-demographic characteristics
Mother first generation immigrant 17 (74 %)
Single parent 6 (17 %)

Prenatal diagnosis: 2007-2014
Early ultrasound 10
Late ultrasound 9
Not diagnosed 4

COMPARISON GROUP
All children with MMC:
* Born 1988 - 1991
* Uppsala/Örebro region
* Surgical closure
22 children (9 boys)

Children with MMC :
born 2007-2014 and 1988-1991
2007 1988 p
Mother immigrant 15/20 1/22 ***
Prenatal diagnosis 16/20 1/22 **
Early shunt 6/20 3/22 *
Ad mortem first mo 3/20 0/22

CONCLUSIONS
Newborn children with MMC today:
1. Mother often first-generation immigrant!
2. Most often prenatally diagnosed!
3. Often severe medical complications!

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