In-Hospital Morbidities for Neonates with Congenital Diaphragmatic Hernia: The Impact of Defect Size and Laterality - 21/12/21
for the
Congenital Diaphragmatic Hernia Study Group
Abstract |
Objective |
To determine in-hospital morbidities for neonates with right-sided congenital diaphragmatic hernia (R-CDH) compared with those with left-sided defects (L-CDH) and to examine the differential effect of laterality and defect size on morbidities.
Study design |
This retrospective, multicenter, cohort study from the international Congenital Diaphragmatic Hernia Study Group registry collected data from neonates with CDH surviving until hospital discharge from 90 neonatal intensive care units between January 1, 2007, and July 31, 2020. Major pulmonary, cardiac, neurologic, and gastrointestinal morbidities were compared between neonates with L-CDH and R-CDH, adjusted for prenatal and postnatal factors using logistic regression.
Results |
Of 4123 survivors with CDH, those with R-CDH (n = 598 [15%]) compared with those with L-CDH (n = 3525 [85%]) had an increased odds of pulmonary (1.7; 95% CI, 1.4-2.2, P < .0001), cardiac (1.4; 95% CI, 1.1-1.8; P = .01), gastrointestinal (1.3; 95% CI, 1.1-1.6; P = .01), and multiple (1.6; 95% CI, 1.2-2.0; P < .001) in-hospital morbidities, with a greater likelihood of morbidity with increasing defect size. There was no difference in neurologic morbidities between the groups.
Conclusions |
Neonates with R-CDH and a larger defect size are at an increased risk for in-hospital morbidities. Counseling and clinical strategies should incorporate knowledge of these risks, and approach to neonatal R-CDH should be distinct from current practices targeted to L-CDH.
Le texte complet de cet article est disponible en PDF.Keywords : congenital diaphragmatic hernia, morbidities, neonate
Abbreviations : L-CDH, R-CDH, CDHSG, ECHO, GI, ECLS, CDH
Plan
| Funded by the Stanford Maternal and Child Health Research Institute, United States for statistical support from the Stanford Quantitative Sciences Unit. The funding source had no role in study design, data collection, analysis, interpretation, or writing of the report. The authors declare no conflicts of interest. |
Vol 240
P. 94 - janvier 2022 Retour au numéro
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