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Risk factors for chronic lung disease and mortality in newborns with congenital diaphragmatic hernia

L van den Hout1, I Reiss, J F Felix

  • 1Intensive Care and Department of Pediatric Surgery, Erasmus MC - Sophia, Rotterdam, The Netherlands.

Neonatology
|November 3, 2010
PubMed

Insights

Congenital diaphragmatic hernia (CDH) significantly impacts neonates, with high rates of mortality and bronchopulmonary dysplasia (BPD). Initial ventilation mode and other factors like defect location and gestational age influence outcomes.

Area of Science:

  • Neonatalogy
  • Pediatric Surgery
  • Respiratory Medicine

Background:

  • Congenital diaphragmatic hernia (CDH) presents a significant mortality risk (10-35%) in live-born infants.
  • Survivors of CDH face a high likelihood of long-term pulmonary complications, including bronchopulmonary dysplasia (BPD).

Purpose of the Study:

  • To identify risk factors for BPD and mortality in neonates diagnosed with CDH.
  • To specifically assess the impact of initial ventilation strategies on CDH outcomes.

Main Methods:

  • Analysis of live-born infants with CDH from 2001-2006 within the CDH Study Group.
  • Primary endpoints included BPD (oxygen dependency at day 30) and/or mortality by day 30.

Main Results:

  • 56% of 2,078 neonates experienced BPD or mortality by day 30; 41% of survivors had BPD.
  • Overall mortality reached 31%.
  • High-frequency oscillatory ventilation, right-sided defects, prenatal diagnosis, lower Apgar scores, cardiac/chromosomal anomalies, and lower gestational age were linked to adverse outcomes.

Conclusions:

  • Despite advances in neonatal care, CDH continues to be associated with substantial BPD and early mortality rates.
  • This study highlights key risk factors impacting prognosis in newborns with CDH.
Abstract

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