Alexandros Sotiriadis

Aristotle University of Thessaloniki, Saloníki, Central Macedonia, Greece

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Publications (68)219.81 Total impact

  • K Chatzistamatiou · A Sotiriadis · T Agorastos
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    ABSTRACT: A systematic review of the literature has been conducted (last update March 2014) for clinical studies reporting the prevalence of human papillomavirus (HPV) in the offspring of HPV-infected women in association to their mode of delivery. A meta-analysis was carried out according to the identification of concordant neonatal to maternal HPV types. Overall eight studies were included in the meta-analysis. Our pooled results, showed that caesarean section is associated with significantly lower rates of HPV transmission than vaginal birth (14.9% vs. 28.2%, risk ratio or RR: 0.515, 95% confidence interval or CI: 0.34-0.78). The number of caesarean sections needed to prevent one case of perinatal infection (number needed to treat or NNT) would be 7.5. As a conclusion it should be noted that caesarean section decreases the risk for perinatal HPV transmission by approximately 46%. Perinatal transmission still occurs in approximately 15% of the children born by caesarean section.
    Journal of Obstetrics and Gynaecology 09/2015; DOI:10.3109/01443615.2015.1030606 · 0.55 Impact Factor
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    ABSTRACT: This study aims to evaluate the diagnostic yield of Comparative Genomic Hybridization microarrays (aCGH) and compare it with conventional karyotype analysis of standard >5 Mb resolution. A total of 1,763 prenatal samples were analyzed by aCGH (CytoChip Focus Constitutional microarrays, BlueGnome, Cambridge). The diagnostic yield of chromosomal abnormalities detected by aCGH was assessed, compared to conventional karyotype analysis. The result was pathogenic/unknown penetrance in 125 cases (7.1%) and a variant of unknown significance (VOUS) was detected in 13 cases (0.7%). Out of the 125 cases with abnormal findings, 110 were also detected by conventional karyotype analysis. The aCGH increment in diagnostic yield was 0.9% (15/1763) and 1.6% when VOUS were included. Stratifying the sample according to indications for prenatal invasive testing, the highest values of diagnostic yield increment were observed for patients positive for second trimester sonographic markers (1.5%) and for the presence of fetal structural anomalies (1.3%). In contrast, the incremental yield was marginal in patients with fetus with increased nuchal translucency (0.5%). The present study indicates that routine implementation of aCCH offers an incremental yield over conventional karyotype analysis, which is also present in cases with "milder" indications, further supporting its use as a first-tier test. This article is protected by copyright. All rights reserved.
    Prenatal Diagnosis 08/2015; DOI:10.1002/pd.4685 · 3.27 Impact Factor
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    ABSTRACT: To test if chorionic villus sampling (CVS) is associated with fetal growth impairment, after controlling for maternal and fetal factors. Case-control study of singleton fetuses whose mothers had undergone CVS (N=442) and 2969 controls. The primary outcomes were the prevalence of birthweight <10(th) centile and birthweight <3(th) centile; the prevalence of preeclampsia was the secondary outcome. Tested predictors in logistic regression analysis included CVS, free beta-hCG MoMs, PAPP-A MoMs, first-trimester mean uterine artery pulsatility index (PI) z-scores, maternal height, BMI, age and smoking. The proportion of newborns with birthweight <10(th) centile (7.9 vs. 6.2%), and <3(rd) centile (1.6 vs. 1.1%) did not differ between the two groups. Maternal age, smoking during pregnancy, PAPP-A MoMs and mean first-trimester uterine PI z-score were significant predictors for these outcomes. Although the prevalence of preeclampsia was higher in the CVS group (3.2 vs 1.3%, OR 2.62, 95%CI 1.41-4.89), the association was abolished in the regression analysis, in which maternal body mass index, free b-hCG levels and mean first-trimester uterine PI z-score were the only significant predictors. CVS is not associated with fetal growth impairment, possibly because the resulting mechanical disruption is compensated by the developing placenta, without significantly impairing its function.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 07/2015; DOI:10.3109/14767058.2015.1059814 · 1.37 Impact Factor
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    ABSTRACT: Background Recent studies support that osteocalcin, apart from its skeletal role, is implicated in glucose homeostasis. Aims of this study were to examine first trimester maternal serum concentrations of osteocalcin in pregnancies that developed gestational diabetes mellitus (GDM) and to create a first trimester prediction model for GDM.DesignCase control study in a prospective cohort of pregnant women. Maternal serum levels of osteocalcin were measured in 40 cases that developed GDM and 94 unaffected controls. First trimester biophysical parameters, biochemical indices, maternal-pregnancy characteristics and osteocalcin concentrations were assessed in relation to GDM occurrence.ResultsIn the GDM group, first trimester osteocalcin serum levels were increased compared to the control group (mean=8.81 ng/ml, SD=2.59 vs. mean= 7.34 ng/ml, SD=3.04, p=0.0058). Osteocalcin was independent of first trimester biophysical and biochemical indices. Osteocalcin alone (OR =1.21, CI: 1.02-1.43, p=0.023) was a significant predictor of GDM (Model R2 = 0.04, AUC=0.61, CI: 0.55-0.72, p<0.001). The combination of maternal and pregnancy characteristics with osteocalcin resulted in an improved prediction model for GDM (Model R2 = 0.21, AUC=0.80, CI: 0.71-0.88, p<0.001). The combined model yields a sensitivity of 72.2 % for 25 % false positive rate.Conclusions First trimester maternal serum levels of osteocalcin are increased in GDM pregnancies. Osteocalcin combined with maternal and pregnancy characteristics, provides an effective screening for GDM at 11 to 14 weeks.This article is protected by copyright. All rights reserved.
    European Journal of Clinical Investigation 07/2015; DOI:10.1111/eci.12500 · 2.73 Impact Factor
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    ABSTRACT: To systematically review and integrate data on the neurodevelopmental outcome of children after administration of a single course of antenatal corticosteroids for threatened preterm labor. MEDLINE, Scopus, CENTRAL, and (inception to August 2014) using combinations of the terms "prenatal," "antenatal," "cortico*," "*steroid*," "betamethasone," "dexamethasone," "neurodevelopment*," "*development*," and "follow-up." We perused the references of the retrieved articles. We included randomized and nonrandomized trials reporting on the neurodevelopmental outcomes of children whose mothers were administered a single course of betamethasone or dexamethasone antenatally for threatened preterm birth as opposed to placebo or no treatment. Summary risk ratio (RR) was calculated for dichotomous data; standardized mean difference was calculated for trials that measured the same outcome but used different methods. Heterogeneity was assessed using the I statistic. Sensitivity and subgroup analyses were planned according to study design, specific steroid, and mean gestational age at birth. A single course of antenatal corticosteroids was associated with reduced risk for cerebral palsy (seven studies; treated: 390 of 5,199, untreated: 146 of 1,379; RR 0.678, 95% confidence interval [CI] 0.564-0.815), psychomotor development index less than 70 (two studies; treated: 783 of 3,049, untreated: 258 of 969; RR 0.829, 95% CI 0.737-0.933), and severe disability (five studies; treated: 1,567 of 4,840, untreated: 475 of 1,211; RR 0.787, 95% CI 0.729-0.850). Steroid treatment increased the rates of intact survival (six studies; treated: 1,082 of 2,013, untreated: 273 of 561; RR 1.186, 95% CI 1.056-1.332). Betamethasone was found to significantly decrease the risk for severe disability and increase the rate of intact survival. Dexamethasone increased the rate of intact survival; however, data for dexametasone and the other planned subgroup analyses were limited (fewer than 1,000 children at most). The major limitations involved inclusion of nonrandomized studies and scarcity of data on finer neurodevelopmental outcomes. A single course of antenatal corticosteroids in women at high risk for preterm birth appears to improve most neurodevelopmental outcomes in offspring born before 34 weeks of gestation.
    Obstetrics and Gynecology 06/2015; 125(6):1385-1396. DOI:10.1097/AOG.0000000000000748 · 5.18 Impact Factor
  • Alexandros Sotiriadis · Elisavet Diamanti · Fotios Chatzinikolaou
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    ABSTRACT: A cranial gap was detected in the left frontal area of a 24-week fetus. Reconstruction of the frontal bones and metopic suture using 3D ultrasound revealed the presence of an additional xiphoid bone extending from the anterior fontanelle to the nasal region between the frontal bones, without other major findings. Postnatal examination confirmed the cranial findings and additionally revealed a coloboma in the left eyelid and bilateral preauricular tags. This is an atypical case of Goldenhar syndrome, highlighting the importance of not adhering to the typical clefting and hemifacial microsomia pattern looking for minor detectable signs (colobomas, tags) when a cranial deformity, however atypical for Goldenhar, is detected.
    Ultrasound in Obstetrics and Gynecology 07/2014; 45(3). DOI:10.1002/uog.14635 · 3.85 Impact Factor
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    ABSTRACT: Introduction: The objective of this study was to define the optimal method and timing of intervention in twin reversed arterial perfusion (TRAP) sequence. Material and methods: During a period of 20 years (1993-2013), we performed endoscopic laser coagulation of umbilical cord vessels or intrafetal laser in 67 pregnancies with TRAP sequence. These data were combined with those reported in the literature to determine the survival rate of the pump twin for different methods and timing of interventions. Results: A variety of techniques were used to interrupt the blood supply to the acardiac twin. Most procedures were performed at or after 16 weeks, and with most methods the survival rate of the pump twin was about 80%. Good results were also obtained for triplet pregnancies. In 18 of 30 cases (60%) diagnosed at 11-14 weeks, there was spontaneous cessation of flow in the acardiac twin before planned intervention at 16-18 weeks, and in 11 of these (61.1%) the pump twin died or suffered brain damage. In 103 pregnancies treated by intrafetal laser at 12-27 weeks, there was no correlation between gestational age at treatment and survival rate, but there was an inverse association between gestational age at treatment and gestational age at birth. Discussion: In TRAP sequence, survival may be improved by elective intervention at 12-14 weeks.
    Fetal Diagnosis and Therapy 04/2014; 35(4). DOI:10.1159/000358593 · 2.94 Impact Factor
  • George Makrydimas · Alexandros Sotiriadis
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    ABSTRACT: About 13% of twins are born before 34 weeks and 7% before 32 weeks. The prediction of preterm birth in twins is based on the same tests as in singleton pregnancies. In twin pregnancies, the cut-off for short cervix at the second trimester scan is less than 25 mm (compared with 15 mm in singletons); length less than 20 mm is associated with 42% risk for birth before 32 weeks and cervical length less than 25 mm is associated with 28% risk for birth before 28 weeks. The measurement of cervical length in pregnancies with symptoms of preterm labour may have limited accuracy in predicting preterm birth. In asymptomatic women, a positive fetal fibronectin test seems to be associated with 35% risk for birth before 32 weeks and 40% risk for birth less than 34 weeks, whereas a negative test decreases the risk to 6% and 17%, respectively. The differences in the predictive value of tests between twins and singletons reflect the diverse pathophysiology of preterm birth between the two groups.
    Best practice & research. Clinical obstetrics & gynaecology 12/2013; 28(2). DOI:10.1016/j.bpobgyn.2013.11.007 · 1.92 Impact Factor
  • Archives of Gynecology and Obstetrics 12/2013; 289(3). DOI:10.1007/s00404-013-3119-y · 1.36 Impact Factor
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    ABSTRACT: Objective To pool published data regarding the sensitivity and specificity of nuchal translucency (NT) in the diagnosis of major congenital heart defects (CHDs) in fetuses with normal karyotype. MethodsMEDLINE and Scopus searches using combinations of the terms nuchal' and cardiac*' were complemented by perusal of references of the retrieved articles and an additional automated search using the search for related articles' function on PubMed. Only fetuses with normal karyotype and major CHDs were analyzed. Weighted estimates were made and summary receiver-operating characteristics curves were constructed. ResultsThe analysis included 20 studies (205 232 fetuses; 537 cases with major CHDs). The pooled sensitivity and specificity of NT > 95(th) centile for diagnosis of major CHDs was 44.4% (95% CI, 39.5-49.5) and 94.5% (95% CI, 94.4-94.6), respectively. The pooled sensitivity and specificity of NT > 99(th) centile was 19.5% (95% CI, 15.9-23.5) and 99.1% (95% CI, 99.1-99.2), respectively. For the subgroup of studies in which NT was measured by Fetal Medicine Foundation-certified operators, the pooled sensitivity and specificity of NT > 95(th) centile was 45.6% (95% CI, 39.6-51.7) and 94.7% (95% CI, 94.6-94.9), respectively. The corresponding estimates for NT > 99(th) centile were 21.0% (95%CI, 16.5-26.1) and 99.2% (95% CI, 99.2-99.3). The pooled positive likelihood ratio for NT > 99(th) centile was 30.5 (95% CI, 24.3-38.6). There was high across-studies heterogeneity for most estimates. Conclusion Approximately 44% of chromosomally normal fetuses with CHDs have NT > 95(th) centile and 20% have NT > 99(th) centile. However, there is high heterogeneity across studies, which largely remains even in subgroup analyses of studies of apparently similar design, potentially indicating the presence of some residual unidentified bias. Copyright (c) 2013 ISUOG. Published by John Wiley & Sons Ltd. Linked Comment: Ultrasound Obstet Gynecol 2013:42:373-373
    Ultrasound in Obstetrics and Gynecology 09/2013; 42(4). DOI:10.1002/uog.12488 · 3.85 Impact Factor
  • Kimon Chatzistamatiou · Alexandros Sotiriadis · Theodoros Agorastos
    Archives of Gynecology 08/2013; 289(3). DOI:10.1007/s00404-013-3010-x · 1.36 Impact Factor
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    A Sotiriadis · S Papatheodorou · G Makrydimas
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    ABSTRACT: To quantify the effect on perinatal outcome in women treated with progesterone for the prevention of preterm birth. MEDLINE and SCOPUS searches, including references of the retrieved articles and additional automated search using the 'search for related articles' PubMed function, were used. Randomized controlled trials assigning women at risk for preterm birth to progesterone or placebo were included (both singleton and multiple pregnancies). Outcomes were neonatal and perinatal death, respiratory distress syndrome (RDS), retinopathy, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH) Grade 3-4, sepsis, admission to the neonatal intensive care unit (NICU) and composite adverse outcome. Sixteen studies (singletons, n = 7; twins, n = 7; triplets, n = 2) were included in the meta-analysis. For singleton pregnancies, progesterone reduced the rates of neonatal death (risk ratio (RR) 0.487 (95% CI, 0.290-0.818)), RDS (RR 0.677 (95% CI, 0.490-0.935)), NICU admission (RR 0.410 (95% CI, 0.204-0.823)) and composite adverse outcome (RR 0.576 (95% CI, 0.373-0.891)). No favorable effect was observed in twins; in fact, progesterone was associated with increased rates of perinatal death (RR 1.551 (95% CI, 1.014-2.372)), RDS (RR 1.218 (95% CI, 1.038-1.428)) and composite adverse outcome (RR 1.211 (95% CI, 1.029-1.425)). No significant effect was observed in triplet pregnancies. Progesterone administration in singleton pregnancies at risk for preterm birth improves perinatal outcomes, but may actually have adverse effects in multiple pregnancies.
    Ultrasound in Obstetrics and Gynecology 01/2013; 40(3):257-66. DOI:10.1002/uog.11178 · 3.85 Impact Factor
  • Article: Reply.
    A Sotiriadis · S Papatheodorou · G Makrydimas
    Ultrasound in Obstetrics and Gynecology 10/2012; 40(4):488. DOI:10.1002/uog.12290 · 3.85 Impact Factor
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    ABSTRACT: Evaluate the results obtained from Quantitative Fluorescent (QF)-PCR and conventional karyotype analysis to determine the advantages and disadvantages of dual testing in prenatal diagnosis. From 1 June 2006 to 1 June 2010, dual testing by QF-PCR and karyotype analysis was performed in 13,500 prenatal samples. The rates of concordant results between the two methods were evaluated and the rates of clinically significant chromosomal abnormalities undetected by QF-PCR were assessed. Abnormal karyotype was found in 320 out of 13,500 cases (2.37%, 95% confidence interval (CI) 2.11-2.63%). From these, QF-PCR did not detect the abnormality in 70 cases (0.52%, 95% CI 0.4-0.64%), whereas 34 had a high/unknown risk of adverse outcome (0.25%, 95% CI 0.17-0.33%). By selectively applying dual testing only at cases with ultrasound findings and/or genetic history, 13 cases of high/unknown risk would have been missed (0.1%, 95% CI 0.05-0.15%). Selective dual testing is expected to achieve a serious beneficial economical outcome and reduce parental anxiety produced by ambiguous cytogenetic findings. However, the percentage of 0.1% undetected clinically significant abnormalities cannot be ignored. A suggestion would include the offering of a choice to the pregnant women, undergoing prenatal screening, by informing them about different approaches and various complications.
    Prenatal Diagnosis 07/2012; 32(7):680-5. DOI:10.1002/pd.3888 · 3.27 Impact Factor
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    ABSTRACT: Objective: To evaluate prospectively the efficacy to screen for congenital heart defects (CHD) during the first trimester nuchal translucency (NT) ultrasound examination by assessing the four chambers' view of fetal heart. Methods: Pregnancies that were examined prospectively by ultrasound in the first trimester (11th-14th week), the second (19th-24th week) and third trimester were included in the study. 3774 fetuses were examined and fetal heart was assessed during the NT scan by examining the four chambers view. Detailed echocardiography was performed during the anomaly and growth scans. Diagnosis of congenital heart defects (CHD) was further confirmed by a fetal cardiologist. Results: The four chambers view was obtained in 99.52% of the cases. CHD were diagnosed in 29 fetuses (0.77%). Thirteen cases (44.8%) were detected during the 11-13 weeks' scan, 14 cases (48.3%) during the anomaly scan, 1 CHD (3.5%) during the third trimester scan and 1 case (3.5%) postpartum. Conclusion: Assessment of the four chambers of fetal heart early in pregnancy was feasible and allowed the detection of 45% of CHD. Additional parameters of fetal cardiac anatomy during the NT scan may further improve the detection rate providing pregnancy management information early in the first trimester.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 06/2012; 25(12). DOI:10.3109/14767058.2012.703716 · 1.37 Impact Factor
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    ABSTRACT: Brain thalami are important for a wide range of sensorimotor and neuropsychiatric functions. This study was carried out to calculate normative values for thalami volume during fetal life. Fetal thalami volumes were measured using 3D ultrasound in 122 normal, singleton fetuses at 20(+0) -34(+6) weeks' gestation. Virtual Organ Computer-aided AnaLysis (VOCAL) was used to obtain a sequence of six sections of each thalamus, starting from the transthalamic view of the brain at an axial plane. Thalamic contour was drawn manually. Volume contrast imaging was used to enhance image quality when needed. The volume of the thalamus distal to the transducer was also measured by a second operator in 30 randomly selected cases, blind to the measurements of the first, to calculate interobserver agreement. Thalamic volume increased with gestational age, following a quadratic equation (R(2) = 0.83). There was no significant difference in volume between the right and left thalamus. The mean volume of each thalamus increased from 0.45 ml at 20(+0) weeks, to 1.39 ml at 28(+0) weeks, to 2.17 ml at 34(+0) weeks. The 95% limits of interobserver agreement for thalamic volume were -14.3% to +17.2%. The increase in thalamic volume with gestation can be described adequately by a quadratic equation. The moderate interobserver repeatability is attributed to the similar echogenicity between the thalamus and its surrounding structures.
    Journal of Clinical Ultrasound 05/2012; 40(4):207-13. DOI:10.1002/jcu.21888 · 0.69 Impact Factor
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    ABSTRACT: The purpose of this study was (1) to explore for socio-demographic factors that could potentially affect the intention of women to vaccinate themselves, their 13-year-old daughter and their 13-year-old son against HPV, and (2) to investigate the main reasons for declining vaccination. A structured questionnaire was used in participants of the project (N = 5,249). Logistic regression analysis was applied in order to examine the correlation between vaccine acceptability and a list of potential predictors. In women declining vaccination, the reported reasons for decline were analyzed. Residence in rural areas and low to medium tiers of family income were the most constant factors in favor of intention to vaccinate. Receiving information from a healthcare professional was found to positively affect vaccine acceptability for the woman herself, but it did not affect her intention to vaccinate her daughter or her son. The acceptance rates decreased significantly after the vaccine became available, both for the women themselves and for their daughters or sons. During the same year, a shift was noted in the reason for declining vaccination; the self-perception of insufficient knowledge significantly decreased and the fear of adverse effects significantly increased in all three cases. Apart from demographic factors which may favor or disfavor vaccine acceptability, the intention to vaccinate decreased significantly and the proportion of women rejecting vaccination for safety concerns increased significantly after the introduction of the vaccine, coinciding with isolated cases of negative publicity and highlighting the potential of misinformation by the media.
    Archives of Gynecology 01/2012; 285(6):1719-24. DOI:10.1007/s00404-011-2208-z · 1.36 Impact Factor
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    A Sotiriadis · S Papatheodorou · G Makrydimas
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    ABSTRACT: To systematically review and, when feasible, pool, published data regarding the prevalence of childhood neurodevelopmental delay in fetuses with increased first-trimester nuchal translucency (NT), normal karyotype and absence of structural defects or identifiable syndromes. MEDLINE and SCOPUS searches using combinations of the terms 'nuchal translucency' AND 'outcome*' were complemented by perusal of the references of the retrieved articles and an additional automated search using the 'search for related articles' PubMed function. Only children with a normal karyotype and no structural defects or syndromic abnormalities were included in the analysis. Between-studies heterogeneity was assessed using the I(2) statistic. The total prevalence of developmental delay in all 17 studies was 28/2458 (1.14%; 95% CI, 0.79-1.64; I(2) = 57.6%). Eight studies (n = 1567) used NT > 99(th) centile as the cut-off; 15 children (0.96%; 95% CI, 0.58-1.58%) were reported as having developmental delay (I(2) = 72.2%). Four studies (n = 669) used the 95(th) centile as the cut-off for increased NT; seven children (1.05%; 95% CI, 0.51-4.88%) were reported as having developmental delay (I(2) = 29.2%). Five studies used 3.0 mm as the cut-off for increased NT; the pooled rate of developmental delay was six of 222 children (2.70%; 95% CI, 1.24-5.77%; I(2) = 0.0%). The rate of neurodevelopmental delay in children with increased fetal NT, a normal karyotype, normal anatomy and no identifiable genetic syndromes does not appear to be higher than that reported for the general population. More large-scale, prospective case-control studies would be needed to enhance the robustness of the results.
    Ultrasound in Obstetrics and Gynecology 01/2012; 39(1):10-9. DOI:10.1002/uog.10143 · 3.85 Impact Factor
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    Alexandros Sotiriadis · George Makrydimas
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    ABSTRACT: To systematically review published data on the neurodevelopment of children that were diagnosed prenatally with isolated agenesis of the corpus callosum. Medline and Scopus searches (1960-July 2011); cross-referencing of retrieved articles. Sixteen reports (132 cases of apparently isolated agenesis of the corpus callosum) were included in the analysis. The rates of normal outcome, borderline or moderate disability and severe disability were 94/132 (71.2%; 95% confidence interval [CI], 63.0-78.3), 18/132 (13.6%; 95% CI, 8.8-20.5), and 22/132 (15.2%; 95% CI, 10.0-22.2), respectively. Magnetic resonance imaging detected additional cerebral abnormalities in 22.5% (95% CI, 12.3-37.5) of apparently isolated agenesis of the corpus callosum cases. In truly isolated agenesis of the corpus callosum (confirmed by magnetic resonance imaging), the rates of normal neurodevelopment and severe disability were 52/69 (75.4%; 95% CI, 64.0-84.0) and 8/69 (11.6%; 95% CI, 6.0-21.2), respectively. Prenatally diagnosed, isolated agenesis of the corpus callosum is usually associated with a favorable outcome. Larger, prospective series are required, as current data are limited, inconsistent, and prevent subgroup analyses (eg, complete vs partial agenesis of the corpus callosum).
    American journal of obstetrics and gynecology 12/2011; 206(4):337.e1-5. DOI:10.1016/j.ajog.2011.12.024 · 4.70 Impact Factor

Publication Stats

1k Citations
219.81 Total Impact Points


  • 2009–2015
    • Aristotle University of Thessaloniki
      • Department of Obstetrics and Gynecology IV
      Saloníki, Central Macedonia, Greece
  • 2012–2013
    • General Hospital Thessaloniki
      Athínai, Attica, Greece
  • 1999–2010
    • University Hospital of Ioannina
      Yannina, Epirus, Greece
  • 2000–2009
    • University of Ioannina
      • • Division of Obstetrics-Gynaecology
      • • Department of Mathematics
      Yannina, Epirus, Greece
  • 2008
    • King's College London
      Londinium, England, United Kingdom
    • ICL
      Londinium, England, United Kingdom
  • 2006–2007
    • King's College Hospital NHS Foundation Trust
      Londinium, England, United Kingdom