Spina bifida--a follow-up study of neonates born from 1991 to 2001.

AIMS: To follow the development of children born with myelomeningocoele.

METHODS: We followed 54 infants born with myelomeningocele between 1991 and 2001 in the Obstetrical Department of the Medical University of Gdansk, Poland.

RESULTS: The mortality rate for live births was 40.8%. 13.0% of the children were stillborn and 5.5% were lost for observation. Late diagnosis, a high localization of the lesion, the presence of other malformations, and low birth weight increased the risk of death. Diagnosis was most commonly made in the 31-35(th) week of pregnancy. For 18.5% of the subjects, the diagnosis was postnatal. There was no correlation between the time and mode of delivery and mental development. Only some of the children were able to walk, to use braces, or use a wheelchair. Most of the children had poor bladder and bowel control. We found a correlation between these dysfunctions and the level of myelomeningocele.

CONCLUSIONS: Myelomeningocoele is associated with high rates of mortality and severe psychomotoric retardation. The localization of the lesion has an impact on survival rate and sphincter control. Mental development depends on neonatal condition after delivery. Mode of delivery does not influence the child's further development.