The role of selected parental and perinatal factors in the future mobility of children with myelomeningocele

Background. Myelomenigocele (MMC) is the most severe form of spina bifida, caused by genetic and environmental components; it has many serious complications in a patient’s future life, where dysfunctional mobility is one of the most troublesome.

Objectives. The aim of our study was to explore the role of selected factors: parental and perinatal in children with myelomenigocele and correlate them with their future motor function.

Material and methods. This retrospective analysis was based on 95 births that occurred from 1985 to 2013. Clinical data were collected using medical records and supplemented by a questionnaire for parents. Standard deviation of WHO scores (Z-scores) for weight, length, and body mass index (BMI) at birth were calculated. Hoffer’s scale was used to assess MMC children’s motor function.

Results. There were no statistically significant differences between 53 girls and 42 boys who were enrolled in the study, excluding the month of conception. The tested parameters did not vary substantially according to maternal age. Maternal age correlated positively with paternal age at conception, birth order, and stillbirth rate. Mode of delivery was strongly associated

with Apgar scale and birth weight. Apgar score, birth length, and thus WHO Z-score for length-for-age had positive correlations with future mobility of MMC children.

Conclusions. 1. Perinatal factors have a significant effect on children’s physical activity. 2. There is no clinical evidence that cesarean section improves early neurological outcome of MMC infants. 3. Parental factors, particularly maternal age, do not determine the future mobility of children with myelomeningocele.