Background and aims: Extensive research has shown that male bodybuilders are at high risk for exercise dependence, but few studies have measured these variables in female bodybuilders. Prior research has postulated that muscular dysmorphia was more prevalent in men than women, but several qualitative studies of female bodybuilders have indicated that female bodybuilders show the same body image concerns. Only one study has compared female bodybuilders with control recreational female lifters on eating behaviors, body image, shape pre-occupation, body dissatisfaction, and steroid use. The purpose of this study was to compare exercise dependence and muscle dysmorphia measures between groups of female weight lifters. Methods: Seventy-four female lifters were classified into three lifting types (26 expert bodybuilders, 10 or more competitions; 29 novice bodybuilders, 3 or less competitions; and 19 fitness lifters, at least 6 months prior lifting) who each completed a demographic questionnaire, the Exercise Dependence Scale (EDS), the Drive for Thinness scale (DFT) of the Eating Disorder Inventory-2, the Bodybuilding Dependence Scale (BDS), and the Muscle Dysmorphia Inventory (MDI). Results: Female bodybuilders scored higher than fitness lifters for EDS Total, BDS Training and Social Dependence, and on Supplement Use, Dietary Behavior, Exercise Dependence, and Size Symmetry scales of the MDI. Discussion and conclusions: Female bodybuilders seem to be more at risk for exercise dependence and muscle dysmorphia symptoms than female recreational weight lifters.

What are the novel findings of this work? This is the largest follow-up study to date evaluating the postnatal mortality and 30-month outcome of children who underwent fully percutaneous fetoscopic repair of myelomeningocele (MMC). What are the clinical implications of this work? Intrauterine repair of MMC by percutaneous fetoscopy, and via hysterotomy, result in a remarkably good outcome concerning mortality, prematurity, shunt-placement rates, motor and mental development and free ambulation, when compared to postnatal repair.

lead to fetal injury and long-term neurodevelopmental complications. We do not have the evidence or answers we need to pinpoint the timing of delivery with great accuracy, but such a study points us toward next steps. What is sorely needed is another study such as DIGITAT that is adequately powered for the long-term outcomes of interest. In addition, we need better tools for screening, diagnosis, and follow-up of FGR. As such incremental studies are conducted and provide more insight; as clinicians, we need to incorporate the data into our day-to-day management of these patients.-ABC)