Risk factors associated with mortality in newborn infants with congenital diaphragmatic hernia

Galletti, María F; Giúdice, Carlos; Dik, Pablo H Brener; Jonusas, Silvia Fernández; Baldini, L.; Mariani, Gonzalo

doi:10.5546/aap.2020.eng.180

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…For Latin American Centers, isolated CDH lethality during the neonatal period is 68%, varying from 23% for mild cases to 97% for severe CDH [6]. Considering CDH associated to congenital anomalies, the lethality rate reported by one middle-income country referral center was 64% [9].…”

Section: Introductionmentioning

confidence: 99%

Congenital diaphragmatic hernia in a middle-income country: Persistent high lethality during a 12-year period

et al. 2023

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Background In high- and middle-income countries, mortality associated to congenital diaphragmatic hernia (CDH) is high and variable. In Brazil, data is scarce regarding the prevalence, mortality, and lethality of CDH. This study aimed to analyze, in São Paulo state of Brazil, the temporal trends of prevalence, neonatal mortality and lethality of CDH and identify the time to CDH-associated neonatal death. Methods Population-based study of all live births with gestational age ≥ 22 weeks, birthweight ≥400g, from mothers residing in São Paulo State, Brazil, during 2004–2015. CDH definition and its subgroups classification were based on ICD-10 codes reported in the death and/or live birth certificates. CDH-associated neonatal death was defined as death up to 27 days after birth of infants with CDH. CDH prevalence, neonatal mortality and lethality were calculated and their annual percent change (APC) with 95% confidence intervals (95%CI) was analyzed by Prais-Winsten. Kaplan-Meier estimator identified the time after birth that CDH-associated neonatal death occurred. Results CDH prevalence was 1.67 per 10,000 live births, with a significant increase throughout the period (APC 2.55; 95%CI 1.30 to 3.83). CDH neonatal mortality also increased over the time (APC 2.09; 95%CI 0.27 to 3.94), while the lethality was 78.78% and remained stationary. For isolated CDH, CDH associated to non-chromosomal anomalies and CDH associated to chromosomal anomalies the lethality was, respectively, 72.25%, 91.06% and 97.96%, during the study period. For CDH as a whole and for all subgroups, 50% of deaths occurred within the first day after birth. Conclusions During a 12-year period in São Paulo State, Brazil, CDH prevalence and neonatal mortality showed a significant increase, while lethality remained stable, yet very high, compared to rates reported in high income countries.

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Section: Introductionmentioning

confidence: 99%

Congenital diaphragmatic hernia in a middle-income country: Persistent high lethality during a 12-year period

et al. 2023

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“…Pulmonary hypertension (PH) in CDH is often refractory and poorly responsive to treatment. Inhaled nitric oxide (iNO) has not improved the combined outcome of death and ECMO use in CDH [15][16][17][18]. Pulmonary vasodilators in left ventricular dysfunction (LVD) with concomitant left-to-right shunting potentially cause pulmonary venous hypertension and consequently pulmonary hemorrhage [19,20].…”

Section: Introductionmentioning

confidence: 99%

Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Prasad

Saha²,

Kumar

2021

Preprint

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There is emerging evidence supporting ventricular function as a prognostic factor in congenital diaphragmatic hernia (CDH). The present systematic review and meta-analysis aimed to determine the predictive value of early ventricular function for survival and extracorporeal membrane oxygenation (ECMO) requirement in newborns with CDH. PubMed, Google Scholar, Cochrane Central Register, Clinical Trial Registry, and Opengrey were accessed. Studies evaluating associations between echocardiographic ventricular function measured ≤ 48 h after birth and survival or ECMO requirement were included. Two independent authors extracted the following data: study and participant characteristics, prognostic factors, and outcome-related data. Eleven studies met the inclusion criteria. Five studies reported on survival, two on ECMO, and four on both outcomes. A moderate risk of bias was found in most of the studies, mainly because of selection, prognostic factors, and confounding biases. For survival (899 participants), pooled sensitivity and specificity were 86% (95% confidence interval [CI], 77–92%) and 44% (95% CI, 25–65%), respectively, in normal left ventricular function. For ECMO need (815 participants), pooled sensitivity and specificity were 39.8% (95% CI, 27–52%) and 88% (95% CI, 80–96%), respectively, in left ventricular dysfunction. Overall certainty of the evidence was graded very low for survival and low for ECMO. Inconsistent reporting of echocardiographic measurements and lack of adjustment for confounding factors were major limitations. Conclusions: Early ventricular dysfunction is a potential prognostic factor in CDH. Standardized echocardiographic measurement reporting and high-quality studies are needed to further elucidate its prognostic significance.

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Ventricular function in congenital diaphragmatic hernia: a systematic review and meta-analysis

2021

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Risk factors associated with mortality in newborn infants with congenital diaphragmatic hernia

Cited by 3 publications

References 27 publications

Congenital diaphragmatic hernia in a middle-income country: Persistent high lethality during a 12-year period

Congenital diaphragmatic hernia in a middle-income country: Persistent high lethality during a 12-year period

Ventricular Function in Congenital Diaphragmatic Hernia: A Systematic Review and Meta-Analysis

Ventricular function in congenital diaphragmatic hernia: a systematic review and meta-analysis

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