,
Stephanie Cruz,
Angela Saulsbery,
Amy Schlegel,
Adolfo Etchegaray,
Eric Sribnick,
Oluyinka Olutoye
Background: Spina bifida (SB) is a relatively common birth defect with the highest prevalence among Hispanics. A randomized controlled trial (MOMS) demonstrated that prenatal repair yielded improved outcomes compared to postnatal repair. However, the social determinants of health can significantly impact the overall well-being of affected individuals or their eligibility for some of these evidenced-based interventions. Methods: We conducted a retrospective observational study to describe and compare the mean Child Opportunity Index (COIs) scores among patients treated at a free-standing children’s hospital who underwent either prenatal or postnatal repair of SB from January 1st, 2012, to December 31st, 2021. We excluded patients with identifiable maternal and fetal contraindications to prenatal repair, as per the MOMS trial eligibility, apart from those pertaining to socio-economic status. RESULTS: Among a total cohort of 51 fetuses, 86% (n = 44) underwent postnatal repair for SB, while 14% (n = 7) received prenatal repair. Patients who underwent prenatal repair exhibited lower COI scores across all domains (education, health, and environment, social and economic) on national, state, and metro levels compared to the postnatal group. Our cohort showed a higher percentage of primary commercial insurance in the prenatal (fetal) surgery group (57.14%) versus the postnatal surgery group (47.73%), without attaining statistical significance (p=0.25). Conclusion: While COI scores across all domains were lower in the prenatal cohort, our data does not suggest a statistically significant difference between prenatal and postnatal surgery groups. This highlights the need for future studies with larger sample sizes to further explore and define this relationship.
| Published in | Advances in Surgical Sciences (Volume 12, Issue 1) |
| DOI | 10.11648/j.ass.20241201.15 |
| Page(s) | 27-35 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Spina Bifida, Fetal Surgery, COI, Health Disparities, MMC, Myelomeningocele
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| [8] | Schechter MS, Liu T, Soe M, Swanson M, Ward E, Thibadeau J. Sociodemographic attributes and spina bifida outcomes. Pediatrics. 2015; 135: e957-964. |
| [9] | Smith KA, Liu T, Freeman KA, et al. Differences in continence rates in individuals with spina bifida based on ethnicity. J Pediatr Rehabil Med. 2019; 12: 361-368. |
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| [11] | Foy AB, Sawin KJ, Derflinger T, et al. Sociodemographic disparities in fetal surgery for myelomeningocele: a single-center retrospective review. J Neurosurg Pediatr. 2021: 1-5. |
| [12] | Fabelo C, He H, Lim FY, Atzinger C, Wong B. Factors impacting surgical decision making between prenatal and postnatal repair for myelomeningocele. Prenat Diagn. 2022; 42: 27-36. |
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| [14] | Harbert AL, Barnett RR, Abumoussa AL, Goodnight WH, Tolleson-Rinehart S, Quinsey CS. Sociodemographic disparities as a determinant of fetal versus postnatal surgical myelomeningocele repair. J Neurosurg Pediatr. 2022: 1-7. |
| [15] | Julie S Moldenhauer, N Scott Adzick. Fetal surgery for myelomeningocele: After the Management of Myelomeningocele Study (MOMS). Semin Fetal Neonatal Med. 2017 Dec; 22(6): 360-366. |
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APA Style
Ogunleye, O., Xia, J., Cruz, S., Saulsbery, A., Nicoll, R., et al. (2024). Health Disparities and Route of Repair of Fetal Myelomeningocele-Prenatal Versus Postnatal Repair. Advances in Surgical Sciences, 12(1), 27-35. https://doi.org/10.11648/j.ass.20241201.15
ACS Style
Ogunleye, O.; Xia, J.; Cruz, S.; Saulsbery, A.; Nicoll, R., et al. Health Disparities and Route of Repair of Fetal Myelomeningocele-Prenatal Versus Postnatal Repair. Adv. Surg. Sci. 2024, 12(1), 27-35. doi: 10.11648/j.ass.20241201.15
AMA Style
Ogunleye O, Xia J, Cruz S, Saulsbery A, Nicoll R, et al. Health Disparities and Route of Repair of Fetal Myelomeningocele-Prenatal Versus Postnatal Repair. Adv Surg Sci. 2024;12(1):27-35. doi: 10.11648/j.ass.20241201.15
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Download@article{10.11648/j.ass.20241201.15,
author = {Oluseyi Ogunleye and Jason Xia and Stephanie Cruz and Angela Saulsbery and Ryan Nicoll and Amy Schlegel and Adolfo Etchegaray and Eric Sribnick and Oluyinka Olutoye},
title = {Health Disparities and Route of Repair of Fetal Myelomeningocele-Prenatal Versus Postnatal Repair
},
journal = {Advances in Surgical Sciences},
volume = {12},
number = {1},
pages = {27-35},
doi = {10.11648/j.ass.20241201.15},
url = {https://doi.org/10.11648/j.ass.20241201.15},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20241201.15},
abstract = {Background: Spina bifida (SB) is a relatively common birth defect with the highest prevalence among Hispanics. A randomized controlled trial (MOMS) demonstrated that prenatal repair yielded improved outcomes compared to postnatal repair. However, the social determinants of health can significantly impact the overall well-being of affected individuals or their eligibility for some of these evidenced-based interventions. Methods: We conducted a retrospective observational study to describe and compare the mean Child Opportunity Index (COIs) scores among patients treated at a free-standing children’s hospital who underwent either prenatal or postnatal repair of SB from January 1st, 2012, to December 31st, 2021. We excluded patients with identifiable maternal and fetal contraindications to prenatal repair, as per the MOMS trial eligibility, apart from those pertaining to socio-economic status. RESULTS: Among a total cohort of 51 fetuses, 86% (n = 44) underwent postnatal repair for SB, while 14% (n = 7) received prenatal repair. Patients who underwent prenatal repair exhibited lower COI scores across all domains (education, health, and environment, social and economic) on national, state, and metro levels compared to the postnatal group. Our cohort showed a higher percentage of primary commercial insurance in the prenatal (fetal) surgery group (57.14%) versus the postnatal surgery group (47.73%), without attaining statistical significance (p=0.25). Conclusion: While COI scores across all domains were lower in the prenatal cohort, our data does not suggest a statistically significant difference between prenatal and postnatal surgery groups. This highlights the need for future studies with larger sample sizes to further explore and define this relationship.
},
year = {2024}
}
TY - JOUR T1 - Health Disparities and Route of Repair of Fetal Myelomeningocele-Prenatal Versus Postnatal Repair AU - Oluseyi Ogunleye AU - Jason Xia AU - Stephanie Cruz AU - Angela Saulsbery AU - Ryan Nicoll AU - Amy Schlegel AU - Adolfo Etchegaray AU - Eric Sribnick AU - Oluyinka Olutoye Y1 - 2024/06/14 PY - 2024 N1 - https://doi.org/10.11648/j.ass.20241201.15 DO - 10.11648/j.ass.20241201.15 T2 - Advances in Surgical Sciences JF - Advances in Surgical Sciences JO - Advances in Surgical Sciences SP - 27 EP - 35 PB - Science Publishing Group SN - 2376-6182 UR - https://doi.org/10.11648/j.ass.20241201.15 AB - Background: Spina bifida (SB) is a relatively common birth defect with the highest prevalence among Hispanics. A randomized controlled trial (MOMS) demonstrated that prenatal repair yielded improved outcomes compared to postnatal repair. However, the social determinants of health can significantly impact the overall well-being of affected individuals or their eligibility for some of these evidenced-based interventions. Methods: We conducted a retrospective observational study to describe and compare the mean Child Opportunity Index (COIs) scores among patients treated at a free-standing children’s hospital who underwent either prenatal or postnatal repair of SB from January 1st, 2012, to December 31st, 2021. We excluded patients with identifiable maternal and fetal contraindications to prenatal repair, as per the MOMS trial eligibility, apart from those pertaining to socio-economic status. RESULTS: Among a total cohort of 51 fetuses, 86% (n = 44) underwent postnatal repair for SB, while 14% (n = 7) received prenatal repair. Patients who underwent prenatal repair exhibited lower COI scores across all domains (education, health, and environment, social and economic) on national, state, and metro levels compared to the postnatal group. Our cohort showed a higher percentage of primary commercial insurance in the prenatal (fetal) surgery group (57.14%) versus the postnatal surgery group (47.73%), without attaining statistical significance (p=0.25). Conclusion: While COI scores across all domains were lower in the prenatal cohort, our data does not suggest a statistically significant difference between prenatal and postnatal surgery groups. This highlights the need for future studies with larger sample sizes to further explore and define this relationship. VL - 12 IS - 1 ER -
The Fetal Center, Nationwide Children’s Hospital, Columbus, The United States; Department of Maternal Fetal Medicine, Nationwide Children’s Hospital, Columbus, The United States
The Fetal Center, Nationwide Children’s Hospital, Columbus, The United States; Department of Surgery, Nationwide Children’s Hospital, Columbus, The United States
Department of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, The United States
Department of Pediatrics, The Ohio State University School of Medicine, Columbus, The United States; Division of Neonatology, Nationwide Children’s Hospital, Columbus, The United States
Department of Maternal Fetal Medicine, Nationwide Children’s Hospital, Columbus, The United States
Department of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, The United States; Department of Neurosurgery, Nationwide Children’s Hospital, Columbus, The United States; Department of Neurosurgery, The Ohio State University College of Medicine, Columbus, The United States
The Fetal Center, Nationwide Children’s Hospital, Columbus, The United States; Department of Surgery, Nationwide Children’s Hospital, Columbus, The United States; Department of Regenerative Medicine, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, The United States; Department of Surgery, The Ohio State University College of Medicine, Columbus, The United States
