{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T13:36:57Z","timestamp":1788010617232,"version":"build-2784847793"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hydrops fetalis encompasses diverse fetal disorders with high perinatal mortality, and contemporary regional data are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a single-center retrospective cohort study at a Saudi tertiary referral hospital (2016\u20132022). Pregnancies with antenatal hydrops (\u22652 fluid-filled compartments) that were delivered at our center were included and classified as immune or non-immune hydrops fetalis (NIHF). For NIHF, multivariable logistic regression identified predictors of (i) live birth vs. intrauterine fetal death (IUFD)\/termination in the antenatal cohort and (ii) one-year survival among live-born infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 63,000 deliveries, the hospital-based birth prevalence of antenatally diagnosed NIHF and immune hydrops was 1.84\/1,000 and 0.22\/1,000, respectively. Among live births, the prevalence was 0.65\/1,000 (NIHF) and 0.16\/1,000 (immune). In the NIHF antenatal cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009116), the outcomes were IUFD 56.9% (66\/116), termination 7.8% (9\/116), and live birth 35.3% (41\/116). Of the 41 live-born infants with NIHF, 43.9% (18\/41) survived to one year of age. In the multivariable analysis, the antenatal factors that were independently associated with IUFD\/termination were earlier gestational age at diagnosis [adjusted odds ratio [aOR] 1.20 per week earlier, 95% confidence interval [CI] 1.09\u20131.31;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001] and fetal pleural effusion (aOR 6.11, 95% CI 2.07\u201317.98;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Among live-born infants with NIHF, gestational age at delivery was the sole independent predictor of one-year survival (aOR 1.55 per additional week, 95% CI 1.09\u20132.22;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). In the immune hydrops subgroup (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200914), most pregnancies received intrauterine transfusion, and the one-year survival was 71.4% (10\/14). Among the ten live-born immune cases, postnatal management was intensive, with intravenous immunoglobulin (IVIG) administration in 100% of cases, double-volume exchange transfusion in 80%, and invasive ventilation in 80%. Forty percent received inhaled nitric oxide, and the median hospital stay was 41 days, reflecting substantial resource use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this seven-year cohort, earlier presentation and pleural effusion identified antenatal NIHF pregnancies at high risk for IUFD\/termination, whereas maturity at delivery was the key determinant of one-year survival in live-born NIHF. Immune hydrops showed comparatively favorable survival with fetal therapy. These data provide birth-prevalence benchmarks for a Middle East tertiary center, supporting guideline-based evaluation, timely fetal-therapy referral, and multidisciplinary care focused on targeted diagnosis and intervention, as well as safe prolongation of gestation where feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1693325","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:33:22Z","timestamp":1777872802000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Immune and non-immune hydrops fetalis in a Saudi tertiary center: etiologies, antenatal predictors, perinatal outcomes, and one-year survival in a seven-year cohort"],"prefix":"10.3389","volume":"14","author":[{"given":"Kamal","family":"Ali","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Department, Women Health Hospital, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs","place":["Riyadh, Saudi Arabia"]},{"name":"King Abdullah International Medical Research Center","place":["Riyadh, Saudi Arabia"]},{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alharbi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Department, Women Health Hospital, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleh","family":"Alshaibi","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Department, Women Health Hospital, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs","place":["Riyadh, Saudi 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