Is laterality of congenital diaphragmatic hernia a reliable prognostic factor? French national cohort study
- 1 July 2020
- journal article
- research article
- Published by Wiley in Prenatal Diagnosis
- Vol. 40 (8), 949-957
- https://doi.org/10.1002/pd.5706
Abstract
Objectives The objective of this study was to assess whether the laterality of congenital diaphragmatic hernia (CDH) was a prognostic factor for neonatal survival. Methods This was a cohort study using the French national database of the Reference Center for Diaphragmatic Hernias. The principal endpoint was survival after hospitalization in intensive care. We made a comparative study between right CDH and left CDH by univariate and multivariate analysis. Terminations and stillbirths were excluded from analyses of neonatal outcomes. Results A total of 506 CDH were included with 67 (13%) right CDH and 439 left CDH (87%). Rate of survival was 49% for right CDH and 74% for left CDH (P < .01). Multivariate analysis showed two factors significantly associated with mortality: thoracic herniation of liver (OR 2.27; IC 95% [1.07-4.76]; P = .03) and lung-to-head-ratio over under expected (OR 2.99; IC 95% [1.41-6.36]; P < .01). Side of CDH was not significantly associated with mortality (OR 1.87; IC 95% [0.61-5.51], P = .26). Conclusion Rate of right CDH mortality is more important than left CDH. Nevertheless after adjusting for lung-to-head-ratio and thoracic herniation of liver, right CDH does not have a higher risk of mortality than left CDH.This publication has 40 references indexed in Scilit:
- Right‐sided congenital diaphragmatic hernia in a decade of fetal surgeryBJOG: An International Journal of Obstetrics and Gynaecology, 2014
- The current profile and outcome of congenital diaphragmatic hernia: A nationwide survey in JapanJournal of Pediatric Surgery, 2013
- Impact of Hospital Volume on In-Hospital Mortality of Infants Undergoing Repair of Congenital Diaphragmatic HerniaAnnals of Surgery, 2010
- Redefining outcomes in right congenital diaphragmatic herniaJournal of Pediatric Surgery, 2008
- Hernie de coupole diaphragmatiqueEMC - Obstétrique, 2007
- Outcomes of Congenital Diaphragmatic Hernia: A Population-Based Study in Western AustraliaPEDIATRICS, 2005
- Impact of a current treatment protocol on outcome of high-risk congenital diaphragmatic herniaJournal of Pediatric Surgery, 2004
- Nihilism in the 1990s: The True Mortality of Congenital Diaphragmatic HerniaPEDIATRICS, 2003
- Congenital diaphragmatic hernia: A meta-analysis of mortality factorsJournal of Pediatric Surgery, 2000
- Congenital diaphragmatic hernia—A tale of two cities: The Toronto experienceJournal of Pediatric Surgery, 1997