%0 Journal Article
%T Neurodevelopmental Outcomes in Children After Fetoscopic Endoluminal Tracheal Occlusion for Severe Congenital Diaphragmatic Hernia: Results From a Multidisciplinary Clinic.
%A Sferra SR
%A Penikis AB
%A Guo M
%A Baschat AA
%A Mogayzel PJ
%A Burton VJ
%A Kunisaki SM
%J J Pediatr Surg
%V 59
%N 7
%D 2024 Jul 20
%M 38599907
%F 2.549
%R 10.1016/j.jpedsurg.2024.03.041
%X <B>BACKGROUND: </B>We compared early neurodevelopmental morbidity in young children with severe CDH who underwent FETO to those without fetal therapy.<BR><B>METHODS: </B>We conducted a prospective study of severe CDH patients undergoing FETO (n = 18) at a single North American center from 2015 to 2021 (NCT02710968). Outpatient survivors (n = 12) were evaluated by a multidisciplinary team and compared to expectantly managed CDH patients. Neurodevelopmental outcomes were assessed using the Capute Scales [Clinical Linguistic and Auditory Milestone Scales (CLAMS) and Cognitive Adaptive Test (CAT)], with a developmental quotient (DQ) < 85 indicative of at-risk for delay.<BR><B>RESULTS: </B>At one year, 58% (n = 7) of FETO patients underwent evaluation, with notable concern for language delay (CLAMS median DQ, 80.1 [interquartile range, 67.6-86.7]). FETO scores improved by 24-months, whereas high severity/non-FETO scores declined [CLAMS median DQ (Difference in DQ), 92.3 (+12.2) vs. 77.1 (-13.4), respectively; p = 0.049]. On the initial CAT, FETO patients had concern for visual motor and problem-solving delays, with a median DQ of 81.3 (62.1-89.4). At 24-months, FETO patients had improving scores [Median CAT DQ, 90.8 (+9.5)], whereas high severity/non-FETO [87.5 (-3.0), p = 0.28] had declining scores.<BR><B>CONCLUSIONS: </B>These initial data suggest that FETO is associated with favorable neurodevelopmental outcomes at 24-months compared to severe CDH under expectant management.<BR><B>METHODS: </B>III.