Details

Autor(en) / Beteiligte

• Garabedian, Charles, MD
• Sfeir, Rony, MD
• Langlois, Carole, MS
• Bonnard, Arnaud, MD, PhD
• Khen-Dunlop, Naziha, MD
• Gelas, Thomas, MD, PhD
• Michaud, Laurent, MD, PhD
• Auber, Fréderic, MD, PhD
• Gottrand, Fréderic, MD, PhD
• Houfflin-Debarge, Véronique, MD, PhD

Titel

Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia?

Ist Teil von

• American journal of obstetrics and gynecology, 2015-03, Vol.212 (3), p.340.e1-340.e7

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2015

Quelle

MEDLINE

Beschreibungen/Notizen

• 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.