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The following is a summary of “Neurodevelopmental Outcomes after Fetoscopic Myelomeningocele Repair,” published in the January 2025 issue of Pediatrics by Corroenne et al.

This study evaluates the neurodevelopmental outcomes of infants following fetoscopic myelomeningocele (MMC) repair and compares these outcomes with children who underwent either open-hysterotomy prenatal repair or postnatal repair. A total of 132 infants were included: 93 underwent prenatal repair (69 fetoscopic and 24 open-hysterotomy), and 39 had postnatal repair. Neurodevelopmental outcomes were assessed at or beyond 18 months by a developmental pediatrician using the Capute Scales Clinical Adaptive Test and Clinical Linguistic & Auditory Milestone Scale (CLAMS)—and/or through parental interviews using the Developmental Profile 3 test. Scores were analyzed against age-specific reference values, with a score of ≥70% defined as “normal.” Comparisons of neurodevelopmental scores were adjusted for the infants’ age at testing and the need for hydrocephalus treatment. Among infants undergoing fetoscopic repair, normal CLAMS results were observed in 25 of 33 cases (75.8%), while normal CAT results were found in 23 of 33 cases (69.7%). 

DP-3 assessments revealed normal social-emotional scores in 60 of 65 cases (92.3%), normal cognitive scores in 55 of 65 cases (84.6%), normal communication in 51 of 65 cases (78.5%), normal adaptive behavior in 48 of 65 cases (73.8%), normal general development in 39 of 65 cases (60%), and normal physical development in 31 of 65 cases (47.7%). Neurodevelopmental outcomes for children who underwent fetoscopic repair were comparable to those of children who had open fetal surgery. However, a significantly higher proportion of children in the fetoscopic group achieved “normal” CLAMS scores (25 of 33 [75.8%] vs. 12 of 39 [30.8%], p<0.01) and “normal” CAT scores (23 of 33 [69.7%] vs. 16 of 39 [41.0%], p=0.04) compared to the postnatal repair group. These findings suggest that laparotomy-assisted fetoscopic MMC repair results in normal neurodevelopmental outcomes in approximately two-thirds of cases assessed at or beyond 18 months of age, with outcomes similar to those observed after open fetal surgery repair.

Source: sciencedirect.com/science/article/abs/pii/S0022347625000125