PDF(Pubmed)
Abstract：
BACKGROUND: Myelomeningocele (MMC) is a prevalent form of neural tube defect. Despite advancements in treatment, MMC still poses significant health risks, including complications leading to chronic disability and mortality. Identifying prognostic risk factors for early outcomes is crucial for tailored intervention strategies.
METHODS: This prospective study involved newborns and infants diagnosed with MMC who underwent surgery between 2020 and 2023 at Urmia University of Medical Sciences. Demographic data and surgical outcomes were collected, and participants were followed up for six months. Statistical analyses were conducted using descriptive statistics, Chi-Square, and independent t-test.
RESULTS: The study included 29 MMC cases, with an incidence rate of 1.4 per 10,000 live births. Lesions were predominantly located in the lumbar spine. Although mortality rates appeared to increase with ascending lesion sites, this trend was not statistically significant. Short-term outcomes revealed high morbidity and mortality rates, with neurological deficits being the most prevalent complication. Multivariable analysis identified head circumference as a significant predictor of adverse outcomes (IRR = 1.37, 95% CI = 1.02 to 1.86, p = 0.04). Furthermore, an increase in birth weight was associated with a reduction in the incidence of requiring a ventriculoperitoneal shunt (IRR = 0.99, 95% CI = 0.998 to 0.999, p = 0.02).
CONCLUSIONS: This prospective study highlights prognostic risk factors for early outcomes in MMC patients, emphasizing the need for personalized intervention strategies. By addressing modifiable risk factors and implementing targeted interventions, healthcare providers can strive to improve outcomes and enhance the quality of life for MMC patients.
METHODS: This prospective study involved newborns and infants diagnosed with MMC who underwent surgery between 2020 and 2023 at Urmia University of Medical Sciences. Demographic data and surgical outcomes were collected, and participants were followed up for six months. Statistical analyses were conducted using descriptive statistics, Chi-Square, and independent t-test.
RESULTS: The study included 29 MMC cases, with an incidence rate of 1.4 per 10,000 live births. Lesions were predominantly located in the lumbar spine. Although mortality rates appeared to increase with ascending lesion sites, this trend was not statistically significant. Short-term outcomes revealed high morbidity and mortality rates, with neurological deficits being the most prevalent complication. Multivariable analysis identified head circumference as a significant predictor of adverse outcomes (IRR = 1.37, 95% CI = 1.02 to 1.86, p = 0.04). Furthermore, an increase in birth weight was associated with a reduction in the incidence of requiring a ventriculoperitoneal shunt (IRR = 0.99, 95% CI = 0.998 to 0.999, p = 0.02).
CONCLUSIONS: This prospective study highlights prognostic risk factors for early outcomes in MMC patients, emphasizing the need for personalized intervention strategies. By addressing modifiable risk factors and implementing targeted interventions, healthcare providers can strive to improve outcomes and enhance the quality of life for MMC patients.
摘要：
背景：脊髓膜膨出（MMC）是神经管缺损的一种常见形式。尽管在治疗方面取得了进展，MMC仍然存在重大的健康风险，包括导致慢性残疾和死亡的并发症。确定早期结局的预后风险因素对于量身定制的干预策略至关重要。
方法：这项前瞻性研究涉及2020年至2023年在Urmia医科大学接受手术的被诊断为MMC的新生儿和婴儿。收集人口统计数据和手术结果，参与者随访6个月.采用描述性统计进行统计分析，卡方,和独立的t检验。
结果：该研究包括29例MMC病例，发病率为每10,000例活产中1.4例。病变主要位于腰椎。尽管死亡率似乎随着病变部位的上升而增加，这一趋势没有统计学意义.短期结果显示高发病率和死亡率，神经功能缺损是最常见的并发症.多变量分析确定头围是不良结局的重要预测因子（IRR=1.37，95％CI=1.02至1.86，p=0.04）。此外，出生体重的增加与需要脑室-腹腔分流术的发生率降低相关(IRR=0.99,95%CI=0.998~0.999,p=0.02).
结论：这项前瞻性研究强调了MMC患者早期预后的危险因素，强调个性化干预策略的必要性。通过解决可修改的风险因素并实施有针对性的干预措施，医疗保健提供者可以努力改善MMC患者的预后并提高其生活质量.
方法：这项前瞻性研究涉及2020年至2023年在Urmia医科大学接受手术的被诊断为MMC的新生儿和婴儿。收集人口统计数据和手术结果，参与者随访6个月.采用描述性统计进行统计分析，卡方,和独立的t检验。
结果：该研究包括29例MMC病例，发病率为每10,000例活产中1.4例。病变主要位于腰椎。尽管死亡率似乎随着病变部位的上升而增加，这一趋势没有统计学意义.短期结果显示高发病率和死亡率，神经功能缺损是最常见的并发症.多变量分析确定头围是不良结局的重要预测因子（IRR=1.37，95％CI=1.02至1.86，p=0.04）。此外，出生体重的增加与需要脑室-腹腔分流术的发生率降低相关(IRR=0.99,95%CI=0.998~0.999,p=0.02).
结论：这项前瞻性研究强调了MMC患者早期预后的危险因素，强调个性化干预策略的必要性。通过解决可修改的风险因素并实施有针对性的干预措施，医疗保健提供者可以努力改善MMC患者的预后并提高其生活质量.
