Congenital diaphragmatic hernia: the hidden mortality

Area of Science:

• Pediatric Surgery
• Neonatalogy
• Public Health

Background:

• Congenital diaphragmatic hernia (CDH) is a severe birth defect with significant mortality.
• Previous estimates of CDH mortality may not fully account for all affected infants.

Purpose of the Study:

• To determine the true incidence and mortality of congenital diaphragmatic hernia (CDH) in Norway.
• To identify the extent of "hidden" mortality in infants with CDH.

Main Methods:

• Retrospective analysis of neonatal deaths and a review of cases treated at a major referral center.
• Inclusion of infants who died shortly after birth and were not admitted to the hospital.

Main Results:

• Congenital diaphragmatic hernia (CDH) occurred in approximately 1 in 5455 live births.
• The operative mortality for treated infants was 30%, but the overall "true" mortality reached 66%.
• A substantial "hidden" mortality was observed, with over half of CDH infants dying before reaching a treatment center.

Conclusions:

• The "true" mortality rate for congenital diaphragmatic hernia (CDH) is significantly higher than previously reported.
• Neonatal death surveys are crucial for understanding the full impact of CDH.
• Early identification and intervention strategies are critical to reduce the substantial hidden mortality associated with CDH.