Intrauterine Myelomeningocele Repair: Effect on Short-Term Complications of Prematurity

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Abstract
Objective: To determine whether short-term complications of prematurity are affected by intrauterine myelomeningocele repair. Methods: Medical records of the first 100 infants undergoing intrauterine myelomeningocele repair (IUMR) at the Vanderbilt University Medical Center were reviewed. Infants born at <34 weeks’ gestation were identified. Two controls were identified for each IUMR infant. Controls were matched for gestational age, sex, birth weight, antenatal steroids, and mode and month of delivery. Development of respiratory distress syndrome, intraventricular hemorrhage, and chronic lung disease and days on ventilator and length of hospital stay were recorded. The results are expressed as mean values and ranges. Comparison of data between groups was performed using the Mann-Whitney U test. Categorical data were compared using the chi-square test and Fisher’s exact test. p ≤ 0.05 was considered statistically significant. Results: One hundred infants underwent IUMR. Forty-four infants were born at <34 weeks of gestation. Complete data were available on 37 infants. Seventy-four matched controls were studied. Eleven infants from the IUMR group and 23 infants from the control group developed respiratory distress syndrome (29.7 vs. 31.1%; p = 0.8). Six infants from the IUMR group and 13 infants from the control group developed chronic lung disease (16.2 vs. 17.5%; p = 0.9). The length of stay was 28 (range 2–82) days for the IUMR group and 24 (range 1–99) days (p = 0.09) for the control group. There was also no significant difference between groups with regard to intraventricular hemorrhage and days on ventilators. Conclusion: There is no difference between short-term complications of prematurity following IUMR and those associated with prematurity resulting from other causes.