Prenatal Surgery Shows Promise For Spina Bifida
Researchers found for the first time that children with spina bifida are more likely to walk and less likely to have neurological difficulties when surgery is done in the womb rather than after birth.
The findings — published online Wednesday in The New England Journal of Medicine — are so encouraging that the eight-year trial was cut short to allow the prenatal surgery to be more widely available.
“For a young couple, finding out their developing child has a problem is one of the most devastating things that can happen. This landmark study offers real hope for improving the lives of children with spina bifida worldwide,” said Diana Farmer, the study’s senior author and surgeon-in-chief at the University of California, San Francisco Benioff Children’s Hospital.
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In a randomized, controlled trial, Farmer and her colleagues focused on 183 mothers whose children were found to have myelomeningocele, a type of spina bifida in which the spinal cord protrudes through an opening on the baby’s back. Typically, children born with the condition have difficulty walking and have a brain abnormality requiring surgery.
Mothers participating in the study were randomly assigned to two groups — one receiving the prenatal surgery and the other group waiting until after birth for their child to undergo a procedure.
Ultimately, when the children were evaluated at age 30 months, those who received the prenatal procedure scored better in mental development and motor skills, researchers said. In addition, 42 percent could walk independently compared to 21 percent of those who were operated on after birth.
Even with the encouraging results, researchers warned that prenatal surgery is not without risk. Mothers who underwent the procedure were more likely to give birth prematurely and will have to deliver by Caesarean section in any future pregnancy.