450: Long term follow up on fetuses with isolated sonographic finding of short long

Abstract

Isolated finding of short long bones, defined below the 5th percentile, diagnosed from second trimester of pregnancy, can be explained as a normal variant in constitutionally small fetuses. Due to lack of information on future prognosis, this finding is still a matter of concern to physicians and patients alike, and often termination of the pregnancy is considered. The aim of this study is to evaluate the long term outcome of fetuses that were born. A retrospective review of all cases of short long bones diagnosed from January 2010 until April 2017 in a single tertiary referral center. Data was collected from the hospital computerized database to identify all cases of short long bones above 18 weeks of gestation during the study period. Exclusion Criteria included: abnormal sonographic findings other than short long bones, suspected genetic syndromes, chromosomal abnormalities, abnormal flows on doppler, incomplete data and lost to follow up. Follow-up of live born infants was carried out by reviewing the pediatric records and by telephone questionnaire on development and growth. During the study period 222 women were diagnosed with short long bones, of them 54 (24.32%) women met inclusion criteria. The mean gestational week of diagnosis of short long bones was 32(±5.05SD), including 34 (63.0%) male and 18(33.3%) female fetuses. Mean delivery week was 38.05 (±2.42 SD), of which 31.5% were delivered by a cesarean delivery. Mean birth weight was 2645g (±684 SD, 95CI 2173-2980) under the 10th percentile by the CDC growth charts. Median time for follow up was 9.3 years (IQR 6.6-10.75) Except OF one neonate diagnosed with juajenal atresia all had no structural anomalies detected... Seven infants (7.4%) had delayed acquisition of developmental milestones. Sixteen males (32.0%) and 11 female (20.37%) were under the 10th percentile height with no significant difference among gender. Eleven children (20.37%) were followed up by pediatric endocrinologist of which 7 ( 12.96%) were treated with growth hormone . Three (5.6%) of the children were diagnosed with Attention Deficit Hyperactivity Disorder, incidence that is considered lower than the general population (±9%). Isolated finding of short long bones diagnosed from second trimester of pregnancy was found to be associated with short stature. No neurodevelopmental impact was observed.