학술논문
Does prenatal diagnosis modify neonatal treatment and early outcome of children with esophageal atresia?
Document Type
Academic Journal
Author
Garabedian, Charles; Sfeir, Rony; Langlois, Carole; Bonnard, Arnaud; Khen-Dunlop, Naziha; Gelas, Thomas; Michaud, Laurent; Auber, Fréderic; Gottrand, Fréderic; Houfflin-Debarge, Véronique; Piolat, Christian; Lemelle, Jean Louis; Fouquet, Virginie; Habonima, Edouard; Becmeur, Francis; Polimerol, Marie Laurence; Breton, Anne; Petit, Thierry; Podevin, Guillaume; Lavrand, Frederic; Allal, Hossein; Lopez, Manuel; Elbaz, Frederic; Merrot, Thierry; Michel, Jean Luc; Buisson, Philippe; Sapin, Emmanuel; Delagausie, Pascal; Pelatan, Cécile; Gaudin, Jean; Weil, Dominique; de Vries, Philline; Jaby, Olivier; Lardy, Hubert; Aubert, Didier; Borderon, Corinne; Fourcade, Laurent; Geiss, Stéphane; Breaud, Jean; Pouzac, Myriam; Echaieb, Anaïs; Laplace, Christophe
Source
American Journal of Obstetrics and Gynecology. Mar 01, 2015 212(3):340e1-340e7
Subject
Language
English
ISSN
0002-9378
Abstract
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.