Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis

Abstract

To evaluate the survival and intact-survival rates among preterm infants with congenital diaphragm hernia (CDH). Study DesignMulticenter retrospective cohort study of 849 infants born between 2006 and 2020 at 15 Japanese CDH study group facilities. Multivariate logistic regression analysis adjusted using inverse probability treatment weighting (IPTW) method was used. We also compare trends of intact-survival rates among term and preterm infants with CDH. ResultsAfter adjusting using the IPTW method for CDH severity, sex, APGAR score at 5 min, and cesarean delivery, preterm infants had a signi cantly lower survival rate [odds ratio (OR), 0.46; 95% con dence interval (CI), 0.22-0.95] and lower intact-survival rate [OR, 0.48; 95% CI, 0.32-0.74] compared with term infants. Trends of intact-survival rates for preterm infants had changed little unlike term infants. ConclusionPrematurity was a signi cant risk factor for survival and intact-survival among infants with CDH, regardless of adjustment for CDH severity.

Neonatal outcome of preterm infants with antenatally diagnosed congenital diaphragmatic hernia: A single center’s experience

“…In infants with CDH, prematurity exacerbates existing challenges associated with the immaturity of various organs, including the lungs. Several studies indicate an increased mortality rate with reduced gestational age (GA) in neonates with CDH [6][7][8][9]. However, whether the increased mortality is attributable to lung immaturity or therapeutic limitations, such as the use of extracorporeal membrane oxygenation (ECMO), remains uncertain.…”