SORA

Advancing, promoting and sharing knowledge of health through excellence in teaching, clinical practice and research into the prevention and treatment of illness

Systematic review and meta-analysis of isolated posterior fossa malformations on prenatal imaging (part 2): neurodevelopmental outcome.

D'Antonio, F; Khalil, A; Garel, C; Pilu, G; Rizzo, G; Lerman-Sagie, T; Bhide, A; Thilaganathan, B; Manzoli, L; Papageorghiou, AT (2016) Systematic review and meta-analysis of isolated posterior fossa malformations on prenatal imaging (part 2): neurodevelopmental outcome. Ultrasound Obstet Gynecol, 48 (1). pp. 28-37. ISSN 1469-0705 https://doi.org/10.1002/uog.15755
SGUL Authors: Papageorghiou, Aris Thilaganathan, Baskaran Bhide, Amarnath Khalil, Asma

[img] Microsoft Word (.docx) Accepted Version
Available under License ["licenses_description_publisher" not defined].

Download (80kB)
[img] Microsoft PowerPoint (Figure 1) Accepted Version
Available under License ["licenses_description_publisher" not defined].

Download (40kB)
[img] Microsoft Word (.docx) (Supplementary Material 1) Accepted Version
Available under License ["licenses_description_publisher" not defined].

Download (17kB)
[img] Microsoft Word (.docx) (Supplementary Material 2) Accepted Version
Available under License ["licenses_description_publisher" not defined].

Download (42kB)

Abstract

OBJECTIVES: Diagnosis of isolated posterior fossa anomalies in children is biased by the fact that only those that are symptomatic are brought to the attention of the appropriate clinical personnel, and the reported rate is often affected by the adoption of different nomenclature, diagnostic criteria, outcome measures, duration of follow-up and neurodevelopmental tools. The aim of this systematic review was to explore the neurodevelopmental outcome of fetuses with a prenatal diagnosis of isolated posterior fossa anomalies. METHODS: MEDLINE and EMBASE were searched electronically, utilizing combinations of the relevant medical subject heading terms for 'posterior fossa' and 'outcome'. Studies assessing the neurodevelopmental outcome in children with a prenatal diagnosis of isolated posterior fossa malformations were considered eligible. The posterior fossa anomalies analyzed included Dandy-Walker malformation (DWM), mega cisterna magna (MCM), Blake's pouch cyst (BPC) and vermian hypoplasia (VH). Two authors reviewed all abstracts independently. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale for cohort studies. Meta-analyses of proportions were used to combine data, and between-study heterogeneity was explored using the I(2) statistic. RESULTS: A total of 1640 articles were identified; 95 were assessed for eligibility and a total of 16 studies were included in the systematic review. The overall rate of abnormal neurodevelopmental outcome in children with a prenatal diagnosis of DWM was 58.2% (95% CI, 21.8-90.0%) and varied from 0-100%. In those with a prenatal diagnosis of MCM, the rate of abnormal neurodevelopmental outcome was 13.8% (95% CI, 7.3-21.9%), with a range of 0-50%. There was no significant association between BPC and the occurrence of abnormal neurodevelopmental delay, with a rate of 4.7% (95% CI, 0.7-12.1%) and range of 0-5%. Although affected by the very small number of studies, there was a non-significant occurrence of abnormal neurodevelopmental delay in children with a prenatal diagnosis of VH, with a rate of 30.7% (95% CI, 0.6-79.1%) and range of 0-100%. CONCLUSIONS: Fetuses diagnosed with isolated DWM are at high risk of abnormal neurodevelopmental outcome, while isolated MCM or BPC have a generally favorable outcome. The risk of abnormal developmental delay in cases with isolated VH needs to be further assessed. In view of the wide heterogeneity in study design, time of follow-up, neurodevelopmental tests used and the very small number of included cases, further future large prospective studies with standardized and objective protocols for diagnosis and follow-up are needed in order to ascertain the rate of abnormal neurodevelopmental outcome in children with isolated posterior fossa anomalies. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

Item Type: Article
Additional Information: This is the peer reviewed version of the following article: D'Antonio, F. , Khalil, A. , Garel, C. , Pilu, G. , Rizzo, G. , Lerman‐Sagie, T. , Bhide, A. , Thilaganathan, B. , Manzoli, L. and Papageorghiou, A. T. (2016), Systematic review and meta‐analysis of isolated posterior fossa malformations on prenatal imaging (part 2): neurodevelopmental outcome. Ultrasound Obstet Gynecol, 48: 28-37, which has been published in final form at https://doi.org/10.1002/uog.15755. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Keywords: Blake's pouch cyst, Dandy-Walker malformation, mega cisterna magna, meta-analysis, neurodevelopmental outcome, posterior fossa anomaly, vermian hypoplasia, Cranial Fossa, Posterior, Female, Humans, Magnetic Resonance Imaging, Nervous System Malformations, Pregnancy, Pregnancy Outcome, Ultrasonography, Prenatal, Blake's pouch cyst, Dandy-Walker malformation, mega cisterna magna, meta-analysis, neurodevelopmental outcome, posterior fossa anomaly, vermian hypoplasia, Blake's pouch cyst, Dandy-Walker malformation, mega cisterna magna, meta-analysis, neurodevelopmental outcome, posterior fossa anomaly, vermian hypoplasia, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Vascular (INCCVA)
Journal or Publication Title: Ultrasound Obstet Gynecol
ISSN: 1469-0705
Language: eng
Dates:
DateEvent
5 July 2016Published
23 September 2015Accepted
PubMed ID: 26394557
Web of Science ID: WOS:000379970700005
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108124
Publisher's version: https://doi.org/10.1002/uog.15755

Actions (login required)

Edit Item Edit Item