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Observed-to-expected MRI fetal lung volume can predict long-term lung morbidity in infants with congenital
Hiroyuki Tsuda1, Tomomi Kotani1, Mayo Miura1
1a Department of Obstetrics and Gynecology , Nagoya University Graduate School of Medicine , Nagoya , Japan.
Insights
Congenital diaphragmatic hernia (CDH) can cause lasting breathing issues in infants. Fetal lung volume (percent FLV) measured by MRI is a key predictor of a CDH infant's need for oxygen therapy at one year old.
Area of Science:
- Pediatric Surgery
- Neonatology
- Pulmonary Medicine
Background:
- Congenital diaphragmatic hernia (CDH) is a serious birth defect impacting infant lung development.
- CDH leads to pulmonary hypoplasia and hypertension, causing long-term respiratory problems.
Purpose of the Study:
- To identify a reliable marker for predicting lung function at one year of age in infants diagnosed with CDH.
- To assess predictors of long-term respiratory morbidity in CDH patients.
Main Methods:
- Analysis of 48 infants with isolated CDH born after 35 weeks gestation.
- Inclusion criteria required at least one year of follow-up for surviving infants.
- Evaluation of parameters including gestational age, amniotic lamellar body count, MRI-derived percent fetal lung volume (percent FLV), liver herniation, and polyhydramnios.
Main Results:
- Several factors predicted mortality in CDH infants, including gestational age, amniotic lamellar body count, percent FLV, liver herniation, and polyhydramnios.
- For surviving infants, only percent FLV significantly predicted the need for oxygen therapy at one year (p < .05).
- A significant negative correlation was observed between percent FLV and the duration of oxygen therapy (r = .516, p < .001).
Conclusions:
- MRI-derived percent fetal lung volume (percent FLV) is a valuable and significant predictor of long-term lung morbidity in infants with congenital diaphragmatic hernia.
- Percent FLV can help anticipate the need for ongoing respiratory support in CDH patients.
Objective:
Congenital diaphragmatic hernia (CDH) causes pulmonary hypoplasia and pulmonary hypertension, which are associated with long-term respiratory problems in infants. The aim of this study was to establish a marker for predicting lung function at 1 year of age in infants with CDH.
Materials And Methods:
Infants with isolated CDH who were delivered after 35 weeks of gestation from April 2008 to June 2016 at Nagoya University Hospital were registered. Regarding alive infants with CDH, only those who underwent follow-up for at least 1 year were registered. Finally, 48 infants were analyzed in this study.
Results:
Gestational age at diagnosis, amniotic lamellar body count at birth, observed-to-expected MRI fetal lung volume (percent FLV), liver herniation, and polyhydramnios were found to be significant parameters for predicting mortality in infants with CDH. Regarding alive infants with CDH, percent FLV was the only significant parameter to predict need for oxygen therapy at 1 year of age (p < .05). There was a significant negative correlation between percent FLV and duration of oxygen therapy in infants with CDH (r = .516, p < .001).
Conclusions:
Percent FLV is a useful predictor of long-term lung morbidity in infants with CDH.
