Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia? - 27/02/15
, Rony Sfeir, MD c, Carole Langlois, MS b, Arnaud Bonnard, MD, PhD d, Naziha Khen-Dunlop, MD e, Thomas Gelas, MD, PhD g, Laurent Michaud, MD, PhD c, Fréderic Auber, MD, PhD f, Fréderic Gottrand, MD, PhD c, Véronique Houfflin-Debarge, MD, PhD aand the
French Network on Esophageal Atresia
Abstract |
Objective |
Our study aimed at (1) evaluating neonatal treatment and outcome of neonates with either a prenatal or a postnatal diagnosis of esophageal atresia (EA) and (2) analyzing the impact of prenatal diagnosis on outcome based on the type of EA.
Study Design |
We conducted a population-based study using data from the French National Register for infants with EA born from 2008-2010. We compared prenatal, maternal, and neonatal characteristics among children with prenatal vs postnatal diagnosis and EA types I and III. We defined a composite variable of morbidity (anastomotic esophageal leaks, recurrent fistula, stenosis) and death at 1 year.
Results |
Four hundred sixty-nine live births with EA were recorded with a prenatal diagnosis rate of 24.3%; 82.2% of EA type I were diagnosed prenatally compared with 17.9% of EA type III (P < .001). Transfer after birth was lower in case of prenatal diagnosis (25.6% vs 82.5%; P < .001). The delay between birth and first intervention did not differ significantly among groups. The defect size was longer among the prenatal diagnosis group (2.61 vs 1.48 cm; P < .001). The composite variables were higher in prenatal diagnosis subset (44% vs 27.6%; P = .003) and in EA type I than in type III (58.1% vs 28.3%; P < .001).
Conclusion |
Despite the excellent survival rate of EA, cases with antenatal detection have a higher morbidity rate related to the EA type (type I and/or long gap). Even though it does not modify neonatal treatment and the 1-year outcome, prenatal diagnosis allows antenatal parental counselling and avoids postnatal transfers.
Le texte complet de cet article est disponible en PDF.Key words : associated anomaly, esophageal atresia, outcome, postnatal diagnosis, prenatal diagnosis
Plan
| The authors report no conflict of interest. |
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| Cite this article as: Garabedian C, Sfeir R, Langlois C, et al. Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia? Am J Obstet Gynecol 2015;212:340.e1-7. |
Vol 212 - N° 3
P. 340.e1-340.e7 - mars 2015 Retour au numéro
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