Perinatal outcomes of infants with congenital limb malformations: an observational study

Abstract

Background: Congenital limb malformations are rare and their perinatal outcomes are not well understood. This study analyzed the perinatal outcomes of infants with congenital limb malformations. Methods: All infants with congenital limb malformations who underwent prenatal assessment and delivery at our tertiary referral center from 2004 through 2017 were retrospectively identified. Neonatal outcome parameters were assessed and the predictors of worse perinatal outcomes were determined. Results: One hundred twenty-four cases with congenital limb malformations were identified, of which 104 (83.9%) were analyzed. The upper limb was affected in 15 (14.4%), the lower limb in 49 (47.1%), and both limbs in 40 cases (38.5%). A fetal syndrome was identified in 66 cases (63.5%); clubfoot and longitudinal reduction defects were the most frequent malformations. In total, 38 cases (36.5%) underwent termination, 7 (6.7%) resulted in stillbirth, and 59 (56.7%) in live-born delivery. Rates of preterm delivery and NICU-transfer were 42.4% and 25.4%, respectively. Localization of the malformation was a determinant of the perinatal outcome and preterm delivery ( P = .006). Conclusions: Congenital limb malformations frequently occur bilaterally, and are associated with poor perinatal outcomes, including high rates of stillbirth and preterm delivery. Multidisciplinary care and referral to a perinatal center are warranted.