Open spina bifida: birth findings predict long-term outcome

Pippa Oakeshott; Gillian M Hunt; Alison Poulton; Fiona Reid

doi:10.1136/archdischild-2011-300624

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Arch Dis Child

doi:10.1136/archdischild-2011-300624

Short reports

Open spina bifida: birth findings predict long-term outcome

¹Population Health Sciences and Education, St George's University of London, London, UK
²Cambridge, UK
³Department of Paediatrics, Sydney Medical School Nepean, University of Sydney, Penrith, Australia

Correspondence to Dr Pippa Oakeshott, Population Health Sciences and Education, St George's University of London, Cranmer Terrace, London SW17 ORE; p.oakeshott{at}sgul.ac.uk

Contributors GMH designed the study with input from PO and AP. FR helped in the analysis of the data. All authors contributed to interpretation of the data. PO and GMH drafted the manuscript and all authors approved the final version.

Received 4 July 2011
Accepted 22 October 2011
Published Online First 25 November 2011

Abstract

Objectives To investigate if lifestyle in spina bifida at age 40±3 years, relates to neurological deficit in infancy or cerebrospinal fluid shunt history.

Design Prospective cohort study with 100% ascertainment.

Setting Community.

Participants 117 consecutive cases of open spina bifida whose backs were closed non-selectively at birth. In 2007, all 46 (39%) survivors and/or carers were surveyed by postal questionnaires and telephone interviews.

Results Of the 38 children with absent sensation only below the knee (sensory level below L3), 23 (61%) survived of whom 14 (61%) were community walkers and only 5 (22%) needed daily care. But in 42 babies with absent sensation up to the umbilicus (sensory level above T11) only seven (17%) survived, none could walk and five (71%) needed daily care. Survivors with no shunt revisions were more likely to walk, live independently and drive a car.

Conclusion Mobility and the need for care at 40 can be predicted from the neurological deficit.

Footnotes

Funding This study was supported by the Association for Spina Bifida and Hydrocephalus (ASBAH), UK.
Competing interests None.
Ethical approval This study was approved by the Huntingdon Research Ethics Committee (Reference 07/Q0104/11).
Provenance and peer review Not commissioned; externally peer reviewed.