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Respiratory morbidities in late preterm and term infants with myelomeningocele

María V Fraga1, Annie Giaccone2, N Scott Adzick2

  • 1Departments of Pediatrics and Surgery, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. fragam@email.chop.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|September 1, 2018
PubMed

Insights

Infants with myelomeningocele (MMC) born via C-section face a high risk of respiratory distress. Over half experienced respiratory issues within 24 hours, highlighting the need for vigilant monitoring.

Area of Science:

  • Neonatal Medicine
  • Pediatric Neurology
  • Respiratory Physiology

Background:

  • Myelomeningocele (MMC) is a complex congenital condition requiring multidisciplinary care.
  • Respiratory morbidities are a significant concern in newborns, particularly those with congenital anomalies.
  • Cesarean section delivery is common in pregnancies complicated by fetal anomalies like MMC.

Purpose of the Study:

  • To determine the incidence of respiratory morbidities in late preterm and term newborns diagnosed with myelomeningocele (MMC).
  • To investigate the occurrence of apnea and the need for caffeine treatment at discharge in this cohort.

Main Methods:

  • A retrospective cohort study was conducted involving 293 infants with MMC born via cesarean section.
  • Infants were categorized by gestational age: late preterm (34 0/7–36 6/7 weeks), early term (37 0/7–38 6/7 weeks), and term (39 0/7–40 6/7 weeks).
  • Primary outcome: incidence of respiratory morbidities within the first 24 hours; Secondary outcome: caffeine treatment for apnea at discharge.

Main Results:

  • Respiratory morbidity was observed in 50.5% of infants within the first 24 hours of life.
  • Apnea occurred in 20.5% of infants during hospitalization, with 17.8% requiring caffeine treatment for persistent apnea or periodic breathing at discharge.
  • The cohort included 106 late preterm, 120 early term, and 67 term infants.

Conclusions:

  • Newborns with myelomeningocele, regardless of gestational age, exhibit a substantially elevated risk of respiratory distress.
  • These findings underscore the critical need for proactive respiratory support and monitoring in neonates with MMC.
Abstract

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