{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T09:49:26Z","timestamp":1782380966627,"version":"3.54.5"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Congenital chylothorax carries a poor prognosis, particularly with delivery at &lt;32 weeks. Survival outcomes under consistent management prioritizing pregnancy prolongation despite worsening hydrops, as well as long-term neurodevelopmental data, remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-center retrospective study, we analyzed fetuses with congenital chylothorax requiring perinatal drainage managed between 2005 and 2021. The protocol prioritized prolonging pregnancy to \u226532 weeks. Postnatally, octreotide and prednisolone were administered stepwise for persistent drainage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 65 fetuses (91% with hydrops), 29 (45%) underwent thoracoamniotic shunting. Fetal death occurred in 10 (15%) and infant death in 11 (17%). Among 55 live-born infants, 30 (55%) received octreotide and 25 (45%) received prednisolone. Of 28 survivors without major congenital anomalies (median gestational age, 35.9 weeks), 20 (71%) underwent Kyoto Scale of Psychological Development assessment at 3 years. Although the median Full-Scale Developmental Quotient (DQ) was 92 (interquartile range: 82\u201398), 40% had DQ\u2009&lt;\u200985 (borderline or delayed). In the Language\u2013Social domain, 55% had DQ\u2009&lt;\u200985. The median Full-Scale Intelligence Quotient on the Wechsler Intelligence Scale for Children was 90 (interquartile range: 86\u201395).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A protocol prioritizing pregnancy prolongation achieved favorable overall survival; however, long-term follow-up remains essential, particularly for Language\u2013Social development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>A perinatal management protocol for congenital chylothorax that prioritizes prolonging pregnancy beyond 32 weeks achieved overall mortality comparable to or lower than previous reports, despite a high prevalence of hydrops fetalis.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Although the median Full-Scale Developmental Quotient at 3 years was within normal, 40% of survivors without major congenital anomalies showed borderline or delayed development, particularly in the Language\u2013Social domain. A similar pattern was observed in school-age Intelligence Quotients.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The median Full-Scale Developmental Quotient at 3 years did not differ between preterm and term infants, indicating that follow-up is necessary even for those born at term.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-026-05271-2","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T09:41:04Z","timestamp":1782380464000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perinatal survival and long-term neurodevelopmental outcomes of congenital chylothorax"],"prefix":"10.1038","author":[{"given":"Hideyuki","family":"Hawaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Shimokaze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Shibasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Nagase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuaki","family":"Toyoshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"5271_CR1","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1111\/j.1651-2227.2006.tb02342.x","volume":"95","author":"G Rocha","year":"2006","unstructured":"Rocha, G. et al. 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An opt-out approach was implemented, and a summary of the study was posted on the hospital\u2019s website (\n                      \n                      ).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent statement"}}]}}