Early neurodevelopmental outcome of infants with high-risk fetal lung lesions.

Abstract:

OBJECTIVE:To evaluate the neurodevelopmental outcome of infants with high-risk fetal lung lesions defined as (1) requiring fetal intervention and/or ex utero intrapartum therapy (EXIT), or (2) acute respiratory decompensation postnatally necessitating emergent resection within 48 h of life. METHODS:We reviewed the medical records of 13 consecutive patients with high-risk fetal lung lesions who were enrolled in our prospective interdisciplinary follow-up program. Neurodevelopmental status was evaluated using the Bayley Scales of Infant Development-III (children ≤3 years, n = 12), or the Wechsler Preschool and Primary Scale of Intelligence-III (children ≥4 years, n = 1). RESULTS:Eight children (62%) underwent prenatal intervention (EXIT, n = 6; fetal resection, n = 1; intrauterine shunt placement, n = 1), and 5 (38%) required emergent resection postnatally. Median age at evaluation was 25 months (range: 5-80). Average scores for cognitive development were found in all children assessed under 3 years of age. The one child who was tested for cognitive ability at 6 years of age scored in the borderline range of intellectual functioning. For language outcome, 15% scored above average, 54% scored within the average range, and 31% had mild deficits. Overall, 77% scored within the average range for neuromotor outcome, while 23% scored within the mildly delayed range. None of the children had severe delays. Cognitive, language, and psychomotor scores were similar between both groups. Hypotonicity was found in 23%. Autism was suspected in one child who underwent an EXIT procedure and was postnatally diagnosed with mosaic trisomy 18. CONCLUSION:The majority of children with high-risk fetal lung lesions have age-appropriate neurodevelopmental scores.

journal_name

Fetal Diagn Ther

authors

Danzer E,Siegle J,D'Agostino JA,Gerdes M,Hoffman C,Bernbaum J,Rintoul NE,Flake AW,Adzick NS,Hedrick HL

doi

10.1159/000336228

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

210-5

issue

4

eissn

1015-3837

issn

1421-9964

pii

000336228

journal_volume

31

pub_type

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