Related Experiment Video
Updated: May 11, 2026
Methods to Quantify Pharmacologically Induced Alterations in Motor Function in Human Incomplete SCI
Published on: April 18, 2011
Mode of Delivery and Subsequent Motor Function in Children With Myelomeningocele Without In Utero Repair
Anna Palatnik1, Amy Y Pan, Stephen P Emery
1Departments of Obstetrics and Gynecology and Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin; University of Pittsburgh Medical Center, Magee-Women's Hospital, and the Children's Hospital of Pittsburgh, Pittsburgh, and the Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; the Department of Neurosurgery, Duke University Medical Center, Duke Children's Hospital, Durham, North Carolina; the University of Michigan, Ann Arbor, Michigan; the Department of Surgery (and Maternal Fetal Care Center), Boston Children's Hospital, Boston, Massachusetts; Children's Minnesota, St. Paul and Minneapolis, Minnesota; the Johns Hopkins Center for Fetal Therapy, Baltimore, Maryland; Vanderbilt University Medical Center, Nashville, Tennessee; Wexner Medical Center, The Ohio State University, Columbus, Ohio; Stanford University School of Medicine, Stanford, and UC Davis Fetal Care and Treatment Center, Sacramento, California; St. Louis University, St. Louis, Missouri; University of Rochester Medical Center, Rochester, New York; and UTHealth Houston Fetal Center, University of Texas McGovern Medical School at Houston, Houston, Texas.
Objective:
To assess the association between mode of delivery and 2-year motor function in children with prenatal diagnosis of myelomeningocele.
Methods:
A multisite retrospective cohort study of children with myelomeningocele across 14 NAFTNet (North American Fetal Therapy Network) centers born between 2007 and 2020 who had a physical examination available at 2 years of life. Exclusion criteria were in utero myelomeningocele repair, postnatal myelomeningocele diagnosis, missing data on fetal presentation at delivery, and contraindications to labor. The primary outcome was the difference between the anatomic level of the spinal lesion and functional motor level at age 2 years. A general linear model was used to determine the effect of mode of delivery on the primary outcome, and multivariable analysis was performed to control for presence of labor, gestational age at delivery, defect size and origin level, and presence of ventriculomegaly.
Results:
Of 566 children with myelomeningocele, 305 met inclusion criteria, with 216 (70.8%) having been delivered by cesarean and 89 (29.2%) having been delivered vaginally. Children delivered by cesarean had a mean±SE level of motor function of 0.07±0.21 segments below the anatomic level at age 2 years compared with 0.57±0.32 for children delivered vaginally ( P =.19). After controlling for potential confounders, both groups improved in motor function by age 2 years compared with anatomic level. However, there was no difference in motor improvement between groups by mode of delivery (0.07 cesarean vs 0.57 vaginal delivery, adjusted difference 0.37 segments, P =.63).
Conclusion:
In this multisite NAFTNet cohort, mode of delivery was not associated with lower-extremity motor function at age 2 years.
Related Concept Videos
01:14Spinal Cord Injury ll: Pathophysiology
01:25Secondary Spinal Cord Injury llI: Pathophysiology