Poster Session 2
Category: Fetal Intervention
Poster Session 2
Nkechinyelum Ogu, MD (she/her/hers)
Maternal-Fetal Medicine Fellow
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Abhinav Reddy, MD
Resident physician
University of Chicago
Chicago, Illinois, United States
Henry David, MD
Assistant Professor of Pediatrics
University of Chicago
Chicago, Illinois, United States
Bahktiar Yamini, MD
Professor of Neurological Surgery
University of Chicago
Chicago, Illinois, United States
Aimen Shaaban, MD
Professor of Surgery and Pediatrics and Director of the CIFH
The Chicago Institute for Fetal Health (CIFH)
Chicago, Illinois, United States
Jessica T. Fry, MD
Associate Professor of Pediatrics
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
Ashish Premkumar, MD, PhD (he/him/his)
Assistant Professor of Obstetrics and Gynecology
University of Chicago
Chicago, Illinois, United States
To evaluate the relationship between household income at the time of prenatal myelomeningocele (MMC) repair and neurodevelopmental outcomes at 30 months of life.
Study Design:
This was an unplanned secondary analysis of individuals undergoing prenatal MMC repair in the Management of Myelomeningocele Study (MOMS). Bivariate analyses were performed comparing families with household income above versus below $50,000 at the time of randomization, which corresponded to the median U.S. household income during the study period (2003-2010). The outcomes were: shunt or death by 1 year of life, difference between the motor function and anatomic level, Bayley Scales of Infant Development (BSID) scores, Peabody Developmental Motor Scales, WeeFIM scores, and ability to walk independently. Wilcoxon rank-sum tests were used for continuous variables and Fisher’s exact or chi-squared tests for categorical variables. A p-value < 0.05 indicated statistical significance.
Results:
Of 91 participants meeting inclusion criteria, 60 (66%) had a household income above $50,000. There were significant differences between groups in multiple sociodemographic markers, though no differences were seen for lesion level, lateral ventricular size, clubfoot, operative duration, and gestational age at delivery (Table 1). At 30 months, children in higher income households had better motor function (p = 0.04). They also had higher BSID mental (p = 0.03) and psychomotor scores (p = 0.01), as well as higher Peabody scores related to locomotion and object manipulation (p < 0.001). A similar pattern was noted for WeeFIM scores related to mobility (p = 0.03, Table 2).
Conclusion:
Household income below $50,000 at the time of prenatal MMC repair is associated with worse functional and neurodevelopmental outcomes at 30 months of life despite similar lesion characteristics. Further research is required to develop novel interventions aimed at ameliorating socioeconomic disparities among people undergoing prenatal MMC repair to improve childhood health outcomes.