Perinatology.  2024 Jun;35(2):44-51. 10.14734/PN.2024.35.2.44.

Comparing the Prognosis of Preterm and Full-Term Infants with Congenital Diaphrag matic Hernia: A Single-Center Study

• Park YM
• Jeong J
• Jung E
• Namgoong JM
• Lee BS

• KMID: 2557568
• DOI: http://doi.org/10.14734/PN.2024.35.2.44

Abstract

Objective
This study aimed to determine the impact of gestational age (GA) cut-off on the clinical outcome of congenital diaphragmatic hernia (CDH) and assess whether prematurity influences the predictive value of fetal lung volume measurement.
Methods
We investigated the medical records of infants with CDH between January 2014 and August 2021. We classified the patients into term CDH (TCDH) and preterm CDH (PCDH) groups and compared their clinical characteristics, including fetal lung volume measured by the observed-toexpected lung-to-head ratio (O/E LHR).
Results
Among 145 infants with CDH, 23 (15.9%) were preterm. Mean O/E LHR was significantly higher in survivors than in non-survivors with no difference between TCDH and PCDH groups. Mortality rate was significantly higher in infants with GA <34 weeks (80%) than in late preterm infants (16.7%). O/E LHR, rather than GA <34 weeks, was a risk factor predicting mortality in multivariate analyses. Predictive power of O/E LHR was high in the TCDH and PCDH groups, respectively. The incidence of chronic lung disease did not differ between PCDH and TCDH.
Conclusion
O/E LHR significantly predicted mortality in preterm infants, suggesting preterm birth alone should not be the determinant of early CDH treatment strategy.

Keyword

Hernia; diaphragmatic; Congenital; Infant; premature; Lung hypoplasia; Extracorporeal membrane oxygenation