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Ultrasound-Guided Prospective Screening for Spinal Dysraphism in Offspring of Mothers With Pregestational Diabetes: A
Saivaroon Gajagowni1, Danielle Mazuru-Witten2, Jessica Hegstrom3
1University of Missouri, School of Medicine, Columbia, Missouri, USA.
Insights
Prospective spinal ultrasound screening in infants of mothers with pregestational diabetes identified one case of tethered cord syndrome. This suggests risk-stratified screening may be beneficial for early diagnosis of spinal dysraphism.
Area of Science:
- Neonatal screening
- Diagnostic imaging
- Pediatric neurology
Background:
- Infants born to mothers with pregestational diabetes (PGDM) are at increased risk for congenital anomalies.
- Spinal dysraphism (SDs) is a significant concern in this population.
- Early diagnosis of SDs is crucial for timely intervention and improved outcomes.
Purpose of the Study:
- To evaluate the effectiveness of prospective spinal ultrasound in diagnosing closed spinal dysraphism (SDs) in infants of mothers with PGDM.
- To assess the utility of this screening method in a high-risk neonatal population.
Main Methods:
- A prospective observational pilot study involving 25 mother-infant dyads.
- Infants with normal spinal physical examinations were screened using spinal ultrasound.
- Follow-up imaging with magnetic resonance imaging (MRI) was performed for abnormal ultrasound findings.
Main Results:
- Three out of 25 (8%) infants screened had abnormal spinal ultrasound findings.
- One case of tethered cord syndrome was diagnosed via MRI following abnormal ultrasound results.
- No significant adverse events were reported during the ultrasound screening.
Conclusions:
- Prospective spinal ultrasound screening identified one case of tethered cord syndrome in infants of mothers with PGDM.
- These findings support the potential utility of risk-stratified screening for SDs in neonates born to diabetic mothers.
- Further research with larger cohorts is warranted to confirm these results.
Aim:
Determine the utility of prospective spinal ultrasound in infants of mothers with pregestational diabetes (PGDM) for the diagnosis of closed spinal dysraphism (SDs).
Methods:
This prospective observational pilot study was completed at a tertiary care center between May 1, 2020 and December 30, 2022. Infants born to mothers with PGDM and with normal spinal physical examinations were included. A total of 25 mother-infant dyads were enrolled in the study and prospectively screened with spinal ultrasound. The study was registered on ClinicalTrials.gov (Identifier-NCT05033275).
Results:
Twenty-five spinal ultrasounds were performed over the course of this study with three (8%) resulting in abnormal findings that required further imaging. Follow-up with magnetic resonance imaging found one case of tethered cord syndrome.
Conclusion:
Prospective screening in infants of mothers with PGDM found one case of tethered cord syndrome. This finding suggests that risk stratified screening of mothers with diabetes might be a reasonable approach to care.
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