Prenatal spina bifida repair better than postnatal repair: JAMA Pediatrics

USA: Prenatal repair of spina bifida (SB) is more beneficial than standard postnatal repair in terms of improving functional mobility and motor levels in children, finds a recent study in the journal JAMA Pediatrics. According to the study, the benefits of prenatal repair for myelomeningocele (a severe form of spina bifida) reported at age 30 months persisted into school age.

The Management of Myelomeningocele Study (MOMS) is a randomized clinical trial of prenatal vs standard postnatal repair for myelomeningocele. It found that prenatal repair reduced hydrocephalus and hindbrain herniation and improved motor function in children aged 12 to 30 months. The Management of Myelomeningocele Study Follow-up (MOMS2) was performed in children aged 5 to 10 years. The primary (neurocognitive) outcome has already been reported.

Amy J. Houtrow, University of Pittsburgh, Pittsburgh, Pennsylvania, and colleagues aimed to determine whether MOMS2 participants who had prenatal repair have better physical functioning than those with postnatal repair.

For the purpose, the researchers recruited participants from MOMS for participation in the follow-up study, MOMS2, conducted from April 9, 2012, to April 15, 2017. For this secondary analysis of the randomized clinical trial, trained examiners without knowledge of the treatment group evaluated the physical characteristics, self-care skills, neurologic function, and mobility of the children. The researchers then compared the physical functioning outcomes between the prenatal and postnatal repair groups.