Prenatal Repair among Children with Myelomeningocele leads t
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The findings of the JAMA study suggest that functional mobility and motor levels are improved for children who underwent prenatal myelomeningocele repair vs standard postnatal repair.

The Management of Myelomeningocele Study (MOMS) found that prenatal repair reduced hydrocephalus and hindbrain herniation and improved motor function in children aged 12 to 30 months. This secondary study was conducted to determine whether MOMS2 participants who had prenatal repair have better physical functioning than those with the postnatal repair.

For this secondary analysis of the randomized clinical trial, examiners evaluated the physical characteristics, self-care skills, neurologic function, and mobility of the children. Physical functioning outcomes were compared between the prenatal and postnatal repair groups. Of the 161 children with myelomeningocele aged 5 to 10 years old enrolled in MOMS2, 154 had a physical examination and were included in the analyses.

This analysis included 78 children with postnatal repair and 76 with prenatal repair. The outcomes showed

--Children in the prenatal repair group were more competent with self-care skills and were commonly community ambulators per the Modified Hoffer Classification.

--Children with prenatal repair also performed the 10-m walk test 1 second faster, had better gait quality, and could perform higher-level mobility skills.

--Children in the prenatal repair group were less likely to have a motor function level worse than their anatomic lesion level.

Conclusively, the physical functioning benefits of prenatal repair for myelomeningocele reported at age 30 months persisted into school age. The findings indicate the benefit of prenatal repair of myelomeningocele for school-aged children.