TABLE 4:
Walking independently and difference between motor function and anatomic level of ≥2 by risk factor in prenatal surgery group
| Factors | Walking independently | Not walking independently | RR (95% Cl) | Pvalue |
|---|---|---|---|---|
| Ultrasound parameters | ||||
| AFI, cm | 15.2 ±2.98 | 14.9 ±2.72 | .74 | |
| BPD, mm | 51.9 ±5.01 | 52.7 ± 5.72 | .78 | |
| HC, mm | 198.8 ±16.79 | 204.6 ±18.95 | .23 | |
| Ankle movement | 31/58 (53%) | 27/58 (47%) | 1.99 (1.01–3.91) | .02 |
| No ankle movement | 7/26 (27%) | 19/26 (73%) | ||
| Knee movement | 38/74 (51%) | 36/74 (49%) | 6.16 (0.93–40.77) | .006 |
| No knee movement | 1/12(8%) | 11/12(92%) | ||
| Hip movement | 39/77 (51%) | 38/77 (49%) | N/A | .003 |
| No hip movement | 0/9 (0%) | 9/9(100%) | ||
| Any clubfoot | 8/23 (35%) | 15/23 (65%) | 0.72 (0.39–1.33) | .26 |
| No clubfoot | 31/64 (48%) | 33/64 (52%) | ||
| Third ventricle dilation | 15/23 (65%) | 8/23 (35%) | 1.74 (1.11–2.73) | .02 |
| No third ventricle dilation | 21/56 (37.5%) | 35/56 (62.5%) | ||
| L3-S1 lesion level | 34/61 (56%) | 27/61 (44%) | 2.90 (1.28–6.57) | .002 |
| Lesion level >L3 | 5/26 (19%) | 21/26 (81%) | ||
| Ventricle measurement, mm | 11.2 ±3.77 | 12.2 ±4.20 | .19 | |
| Ventricle measurement ≥15 mm | 6/18(33%) | 12/18 (67%) | 0.70 (0.35–1.40) | .27 |
| Ventricle measurement <15 mm | 33/69 (48%) | 36/69 (52%) | ||
| Ventricle measurement <10 mm | 16/29 (55%) | 13/29 (45%) | 1.39 (0.88–2.20) | .17 |
| Ventricle measurement ≥10 mm | 23/58 (40%) | 35/58 (60%) | ||
| Cerebellar measurement below FM, mm | 17.8 ±2.08 | 18.9 ±2.72 | .25 | |
| MRI parameters | ||||
| Severe hindbrain herniation | 8/24 (33%) | 16/24 (67%) | 0.68 (0.36–1.26) | .18 |
| Mild/moderate hindbrain herniation | 31/63 (49%) | 32/63 (51%) | ||
| Any structural abnormalities, brain | 2/5 (40%) | 3/5 (60%) | 0.90 (0.30–2.71) | 1.00 |
| No structural abnormalities, brain | 36/81 (44%) | 45/81 (56%) | ||
| Severe cerebellar herniation | 13/29 (45%) | 16/29 (55%) | 1.02 (0.62–1.68) | .93 |
| Mild/moderate cerebellar herniation | 25/57 (44%) | 32/57 (56%) | ||
| Sac over lesion | 23/62 (37%) | 39/62 (63%) | 0.58 (0.37–0.90) | .02 |
| No sac over lesion | 16/25 (64%) | 9/25 (36%) | ||
| Difference, between functional and anatomic, of ≥2 levels better | Difference, between functional and anatomic, of <2 levels better | |||
| Ultrasound parameters | ||||
| AFI, cm | 14.2 ±2.85 | 15.3 ±2.78 | .13 | |
| BPD, mm | 51.0 ±4.32 | 52.8 ± 5.71 | .24 | |
| HC, mm | 197.9 ± 13.24 | 203.5 ±19.50 | .18 | |
| Ankle movement | 19/58 (33%) | 39/58 (67%) | 2.13 (0.80–5.64) | .10 |
| No ankle movement | 4/26 (15%) | 22/26 (85%) | ||
| Factors | Walking independently | Not walking independently | RR (95% Cl) | Pvalue |
| Knee movement | 22/74 (30%) | 52/74 (70%) | 3.57 (0.54–24.07) | .17 |
| No knee movement | 1/12(8%) | 11/12(92%) | ||
| Hip movement | 22/77 (29%) | 55/77 (71%) | 2.57 (0.39–16.87) | .43 |
| No hip movement | 1/9(11%) | 8/9 (89%) | ||
| Any clubfoot | 2/23 (9%) | 21/23 (91%) | 0.27 (0.07–1.04) | .02 |
| No clubfoot | 21/64 (33%) | 43/64 (67%) | ||
| Third ventricle dilation | 4/23 (17%) | 19/23 (83%) | 0.65(0.24–1.75) | .37 |
| No third ventricle dilation | 15/56 (27%) | 41/56 (73%) | ||
| L3—S1 lesion level | 13/61 (21%) | 48/61 (79%) | 0.55(0.28–1.10) | .10 |
| Lesion level >L3 | 10/26 (38%) | 16/26 (62%) | ||
| Ventricle measurement, mm | 11.0 ± 3.11 | 12.0 ±4.29 | .34 | |
| Ventricle measurement ≥15 mm | 2/18(11%) | 16/18 (89%) | 0.37(0.09–1.41) | .14 |
| Ventricle measurement <15 mm | 21/69 (30%) | 48/69 (70%) | ||
| Ventricle measurement <10 mm | 9/29 (31%) | 20/29 (69%) | 1.29(0.63–2.61) | .49 |
| Ventricle measurement ≥10 mm | 14/58 (24%) | 44/58 (76%) | ||
| Cerebellar measurement below FM, mm | 17.6 ±2.26 | 18.8 ±2.54 | .20 | |
| MRI parameters | ||||
| Severe hindbrain herniation | 8/24(33%) | 16/24 (67%) | 1.40 (0.68–2.87) | .37 |
| Mild/moderate hindbrain herniation | 15/63 (24%) | 48/63 (76%) | ||
| Any structural abnormalities, brain | 1/5 (20%) | 4/5 (80%) | 0.77(0.13–4.63) | 1.00 |
| No structural abnormalities, brain | 21/81 (26%) | 60/81 (74%) | ||
| Severe cerebellar herniation | 10/29 (34%) | 19/29 (66%) | 1.64 (0.81–3.33) | .18 |
| Mild/moderate cerebellar herniation | 12/57 (21%) | 45/57 (79%) | ||
| Sac over lesion | 11/62 (18%) | 51/62 (82%) | 0.37(0.19–0.72) | .004 |
| No sac over lesion | 12/25 (48%) | 13/25 (52%) | ||
Data presented as no. of patients (%) or mean ± SD unless otherwise stated.
AFI, amniotic fluid index; BPD, biparietal diameter; CI, confidence interval; FM, foramen magnum; HC, head circumference; MRI, magnetic resonance imaging; N/A, not applicable; RR, relative risk.
Farmer et al. Management of Myelomeningocele Study. Am J Obstet Gynecol 2018.