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Health disparities revealed in a case of congenital LCMV

Pediatric Research volume 95, pages 579–580 (2024)Cite this article

We welcomed a mother to the bedside of her newborn just admitted to our NICU. She was recovering from a cesarean section, every movement in her wheelchair deliberate and ginger. Her baby was adorable. We were all thrilled that this full-term newborn was breathing and rooting spontaneously under the warmer bed. The mother felt elated but confused. Wasn’t something supposed to be terribly wrong? What happened to the pressure on her daughter’s brain that deeply concerned scores of subspecialists? Is it still there? Does this mean she won’t need surgery? As the questions kept coming, we all sat down together and went over the whole story.

After a normal routine anatomy scan at 20 weeks’ gestation, the mother’s obstetrician discovered massive cerebral ventriculomegaly on prenatal imaging at 38 weeks’ gestation. Understandably, the sudden discovery of a severe birth defect was a shock to the mother. It was also a shock to our medical team. Even at our referral center, it was one of the most extreme cases of ventriculomegaly many of us had ever seen. Only a tiny rim of cortical tissue was visible on the latest prenatal ultrasound, which we reviewed with the mother at the bedside. As we scrolled through the images, we worried about this baby’s short- and long-term outcomes. To start, she would almost certainly need a ventriculo-peritoneal shunt, with its attendant complications. We hoped that she could safely eat by mouth, but that remained to be determined. We doubted whether she would ever walk, talk, and learn with her peers.

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Acknowledgements

This work was supported by NIH (NIAID) K08AI151265 and the Children’s Hospital of Philadelphia Research Institute (to S.M.G).

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Author notes

  1. These authors contributed equally: Natalie R. Olivieri, Loui Othman.

Authors and Affiliations

  1. Division of Neonatology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Natalie R. Olivieri, Loui Othman & Scott M. Gordon

  2. Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Scott M. Gordon

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  1. Natalie R. Olivieri
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  2. Loui Othman
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  3. Scott M. Gordon
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N.R.O., L.O., and S.M.G. conceptualized and wrote the article.

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Correspondence to Scott M. Gordon.

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Olivieri, N.R., Othman, L. & Gordon, S.M. Health disparities revealed in a case of congenital LCMV. Pediatr Res 95, 579–580 (2024). https://doi.org/10.1038/s41390-023-02772-2

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