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Follow-up of children with antenatally diagnosed idiopathic polyhydramnios
Magdalena Adamczyk1, Jakub Kornacki2, Przemyslaw Wirstlein2
1Division of Reproduction, Department of Gynecology and Obstetrics, Poznan University of Medical Sciences, Poland. oddzpiv@gmail.com.
Insights
Idiopathic polyhydramnios in newborns can be linked to various developmental issues, including neuromuscular and functional disorders, despite parental reports of normal development. Early identification and follow-up are crucial for affected children.
Area of Science:
- Perinatal Medicine
- Developmental Pediatrics
- Obstetrics
Background:
- Idiopathic polyhydramnios, diagnosed during pregnancy, necessitates understanding long-term child development.
- Previous research has not fully elucidated the developmental outcomes for children with this condition.
Purpose of the Study:
- To assess the 12-month developmental trajectory of children diagnosed with idiopathic polyhydramnios antenatally.
- To identify potential risk factors and associated abnormalities in this cohort.
Main Methods:
- Retrospective analysis of 91 healthy pregnant patients with idiopathic polyhydramnios.
- Data collection included diagnostic tests and perinatal history.
- Parental follow-up via phone and mail to assess child development.
Main Results:
- 44% of children exhibited developmental abnormalities, including neuromuscular and functional disorders.
- 19% had minor malformations, and 3% with small for gestational age (SGA) were diagnosed with genetic syndromes.
- Parental subjective assessment of normal development contrasted with objective findings of abnormalities.
Conclusions:
- Idiopathic polyhydramnios is associated with significant developmental abnormalities requiring long-term monitoring.
- Functional disorders and neuromuscular issues may underlie idiopathic polyhydramnios.
- SGA with idiopathic polyhydramnios indicates a risk for genetic diseases, warranting further investigation.
Objectives:
The aim of our work was to assess the development of children with antenatally diagnosed idiopathic poly- hydramnios, over 12 months from the end of pregnancy.
Material And Methods:
The study included 91 healthy pregnant patients with idiopathic polyhydramnios. Diagnostic tests results and perinatal medical history were obtained retrospectively. Parents of children were contacted by phone and by mail. The answers were obtained from 64 (70%) parents. For statistical analysis SigmaStat3.5 software was used.
Results:
Ninety six percent of parents declared that in their opinion the development of children was normal. Abnormali- ties were found in 44% of the children. Thirty percent of neonates demonstrated mild abnormalities which may be due to organic or functional neuromuscular disorders: abnormal muscle tone, speech apparatus and development disorders, swallowing and breathing problems (manifested as vomiting, excessive regurgitation, idiopathic apnoeas). Isolated small malformations were diagnosed in 12 (19%) children. Two children (3%) with SGA were diagnosed with genetic syndromes. More than one of the abnormalities described above were diagnosed in 14% of children. Gestational age at the time of polyhydramnios diagnosis and its severity were not prognostic factors for abnormalities. Seventy percent of newborns were male.
Conclusions:
Despite the subjectively positive assessment of the development of children by the majority of parents, groups of common disorders requiring long-term follow-up have been identified. Functional disorders of the gastrointestinal tract, CNS and the group of neuromuscular disorders may be responsible for idiopathic polyhydramnios. SGA with co-existing idiopathic polyhydramnios is associated with the risk of genetic diseases. The more frequent incidence of idiopathic poly- hydramnios in male fetuses requires further research.
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