Long-term follow-up of infants after transcervical chorionic villus sampling and after amniocentesis to compare congenital abnormalities and health status.

OBJECTIVES

Next to procedure-related fetal loss, other adverse effects of invasive prenatal diagnosis have been reported: limb defects after chorionic villus sampling (CVS) or early amniocentesis and respiratory distress after amniocentesis (AC). Because minor abnormalities may be overlooked in routine follow-up, we obtained long-term follow-up data after CVS and AC.

METHODS

1509 women with a singleton pregnancy who had transcervical CVS were matched by age and season of conception with 1509 women with singleton pregnancies who had AC. All procedures were performed during 1985-1991 for advanced maternal age >35 years. Data regarding congenital malformations (classified according Eurocat), neonatal and paediatric morbidity and complications of motor development, speech, hearing and visual function were obtained by questionnaire in 1993-1995.

RESULTS

Short-term outcome was known in all but ten infants. Questionnaires with a structured design were mailed to all women with a surviving infant (n=2810); 86.7% responded. No difference was detected between infants after CVS compared with infants after AC regarding congenital malformations (7.2% versus 6.3%), neonatal morbidity (15.1% versus 15.9%), paediatric morbidity with clinical treatment (7.7% versus 6.3%) or outpatient treatment only (43.9% versus 40.3%) and evident function disturbance (2.0% versus 2.0%) or doubtful function disturbance (6.3% versus 6.8%). The number of infants with physical growth <10th centile for Dutch infants was equal (10.1%). Sub-analysis for limb abnormalities or respiratory complications did not demonstrate differences between infants after CVS and AC. Only 10% of all congenital malformations were already known through routine post-partum follow-up.

CONCLUSIONS

An extensive long-term survey could not demonstrate differences of health status between infants after prenatal diagnosis by transcervical CVS and AC.