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Prognostic factors of congenital diaphragmatic hernia accompanied by cardiovascular malformation

Shigehiro Takahashi1, Haruhiko Sago, Yutaka Kanamori

  • 1Division of Neonatology, Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan. takahashi-s@ncchd.go.jp

Pediatrics International : Official Journal of the Japan Pediatric Society
|April 10, 2013
PubMed

Insights

Infants with congenital diaphragmatic hernia and cardiovascular malformation have a poor prognosis. Severe cardiovascular malformations significantly increase mortality and morbidity risks compared to the hernia

Area of Science:

  • Pediatric Surgery
  • Neonatal Cardiology
  • Congenital Malformations

Background:

  • Congenital diaphragmatic hernia (CDH) frequently co-occurs with cardiovascular malformations (CVM).
  • Limited data exists on prognostic factors for infants with concurrent CDH and CVM.
  • This study investigates CDH with CVM in infants.

Purpose of the Study:

  • To evaluate the prognosis of infants diagnosed with both CDH and CVM.
  • To identify factors influencing mortality and morbidity in this patient group.

Main Methods:

  • Retrospective cohort study utilizing Japanese CDH patient data (2006-2010).
  • Examined frequency and outcomes of CVM in infants with CDH.
  • Compared severity of CDH and CVM as predictors of mortality/morbidity.

Main Results:

  • CVM was present in 12.3% of 614 CDH infants.
  • Severe CVM occurred in 66.1% of affected infants.
  • Overall survival was 46.4%; survival without morbidity was 23.2%.
  • Severe CVM strongly predicted mortality (aOR 7.69) and morbidity (aOR 7.93) compared to CDH severity.

Conclusions:

  • Infants with CDH and CVM face a poor prognosis.
  • Cardiovascular malformation severity is a critical predictor of adverse outcomes.
  • Early assessment of CVM severity is crucial for managing these complex cases.
Abstract

Keywords:
cardiac anomalydiaphragmatic hernialiver herniationprognostic factor

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