{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T19:46:44Z","timestamp":1784058404761,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R13HD059293"],"award-info":[{"award-number":["R13HD059293"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In utero fetal spina bifida repair decreases the risk for cerebrospinal fluid (CSF) diversion including ventriculoperitoneal (VP) shunt placement, reverses hindbrain herniation, and improves motor function with a higher likelihood of independent ambulation. Unfortunately, in utero surgery can be complicated by preterm delivery. The goal of this study was to compare pregnancy and neonatal outcomes between individuals who delivered very preterm, and those who delivered later in gestation following in utero spina bifida repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data from the North American Fetal Therapy Network Fetal Myelomeningocele Consortium Registry collected from 2011 to 2024 were analyzed. Three cohorts of patients were categorized by gestational age at delivery and compared: &lt;30 weeks, 30\u201334 weeks, and &gt;34 weeks. Comparisons between groups for maternal and delivery outcomes were completed for the entire cohort and then analyzed for those with available CSF diversion data up to 1 year of life. Chi\u2010square or Fisher's exact tests were used to compare categorical variables, and Kruskal\u2013Wallis tests were used to determine if there are significant differences between the distributions of the three groups. A\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt;0.05 was considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1213 patients were analyzed (&lt;30 weeks,\n                      <jats:italic>n<\/jats:italic>\n                      = 111 [9.2%]; 30\u201334 weeks,\n                      <jats:italic>n<\/jats:italic>\n                      = 323 [26.6%]; &gt;34 weeks,\n                      <jats:italic>n<\/jats:italic>\n                      = 779 [64.2%]). Overall fetal and neonatal mortality was 2.2%, 85% of which occurred in the &lt;30\u2010week cohort, where perinatal mortality was 21%. Latency from fetal surgery to delivery averaged 2.1 weeks for the &lt;30\u2010week group. Rates of abruption, chorioamnionitis, and spontaneous labor were higher in the &lt;30\u2010week group compared to later gestational age cohorts. Neonatal morbidity was also significantly higher in the &lt;30\u2010week cohort for sepsis, apnea, respiratory distress, patent ductus arteriosus, intraventricular hemorrhage, and periventricular leukomalacia in the &lt;30\u2010week cohort. CSF diversion data were available for 677 neonates (&lt;30 weeks,\n                      <jats:italic>n<\/jats:italic>\n                      = 53; 30\u201334 weeks,\n                      <jats:italic>n<\/jats:italic>\n                      = 186; &gt;34 weeks,\n                      <jats:italic>n<\/jats:italic>\n                      = 438). There was no significant difference in VP shunt placement between the different gestational age groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Very preterm birth following in utero spina bifida repair results in significant perinatal mortality and neonatal morbidity. Delivery prior to 30 weeks of gestation occurs in 9% of patients after in utero spina bifida repair, resulting in a 21% perinatal mortality rate. However, even among those who delivered very preterm, a reduction in VP shunt rates, a benefit of in utero repair, appears to be preserved. Further data are warranted to assess the impact of prematurity following in utero surgery on ambulation and developmental outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70027","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T20:37:16Z","timestamp":1746045436000},"source":"Crossref","is-referenced-by-count":3,"title":["Effect of very preterm delivery on outcomes following in utero spina bifida repair"],"prefix":"10.1002","volume":"1","author":[{"given":"Michael V.","family":"Zaretsky","sequence":"first","affiliation":[{"name":"Colorado Fetal Care Center University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagruti","family":"Anadkat","sequence":"additional","affiliation":[{"name":"The Fetal Care Center Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly A.","family":"Bennett","sequence":"additional","affiliation":[{"name":"The Fetal Center at Venderbilt Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair J.","family":"Blumenfeld","sequence":"additional","affiliation":[{"name":"Lucile Packard Children's Hospital Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Buchanan","sequence":"additional","affiliation":[{"name":"St. Louis Fetal Care Institute Saint Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Clifford","sequence":"additional","affiliation":[{"name":"Fetal Diagnosis and Treatment Center University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Crombleholme","sequence":"additional","affiliation":[{"name":"Connecticut Children's Fetal Care Center University of Connecticut School of Medicine  Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Elbabaa","sequence":"additional","affiliation":[{"name":"Orlando Health Center for Fetal Care Orlando Health Arnold Palmer Hospital for Children  Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P.","family":"Emery","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Hospital of the University of Pittsburgh Medical Center University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William H.","family":"Goodnight","sequence":"additional","affiliation":[{"name":"UNC Collaborative for Maternal and Infant Health University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanmin","family":"Lee","sequence":"additional","affiliation":[{"name":"UCSF BCH Fetal Treatment Center University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"Lillegard","sequence":"additional","affiliation":[{"name":"Midwest Fetal Care Center Children's Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Foong\u2010Yen","family":"Lim","sequence":"additional","affiliation":[{"name":"Cincinnati Children's Fetal Care Center Cincinnati Children's Hospital  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois I.","family":"Luks","sequence":"additional","affiliation":[{"name":"Fetal Treatment Program of New England Hasbro's Children's Hospital  Providence Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Lijewski","sequence":"additional","affiliation":[{"name":"Colorado Fetal Care Center University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jena L.","family":"Miller","sequence":"additional","affiliation":[{"name":"Johns Hopkins Center for Fetal Therapy Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ueli","family":"Moehrlen","sequence":"additional","affiliation":[{"name":"Children's Hospital Zurich  Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Moldenhauer","sequence":"additional","affiliation":[{"name":"Richard D. 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