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Trends, correlates, and survival of infants with congenital diaphragmatic hernia and its subtypes.
- Source :
-
Birth defects research [Birth Defects Res] 2018 Aug 15; Vol. 110 (14), pp. 1107-1117. Date of Electronic Publication: 2018 Aug 06. - Publication Year :
- 2018
-
Abstract
- Objective: To identify the live-birth prevalence, trends, correlates, and neonatal and 1-year survival rates of congenital diaphragmatic hernia.<br />Methods: Using a population-based, retrospective cohort study design, we examined 1,025 cases of congenital diaphragmatic hernia from the 1998-2012 Florida Birth Defects Registry. We used Poisson and joinpoint regression models to compute prevalence ratios and temporal trends, respectively. Kaplan-Meier survival curves and Cox proportional hazards regression were used to describe neonatal and 1-year survival and estimate hazard ratios representing the predictors of infant survival.<br />Results: The birth prevalence of congenital diaphragmatic hernia was 3.19 per 10,000 live births (95% confidence interval [CI]: 3.00-3.39); there was a 4.2% yearly increase among multiple cases only. Among all cases, maternal education less than high school (prevalence ratio: 1.25, 95% CI: 1.02-1.53), high school/associate degree/GED (prevalence ratio: 1.15, 95% CI: 1.01-1.32), multiple birth (prevalence ratio: 1.38, 95% CI: 1.05-1.81), and male sex (prevalence ratio: 1.18, 95% CI: 1.05-1.32) were associated with increased risk for congenital diaphragmatic hernia. The 24-hr, neonatal, and 1-year survival rates were 93.6%, 79.8%, and 71.2%, respectively. The highest hazard ratio of 17.87 (95% CI: 1.49-213.82) was observed for neonatal mortality among cases associated with chromosomal anomalies and born <37 weeks at < 1,500 g. Among isolated cases, multiple birth (hazard ratio: 0.41, 95% CI: 0.20-0.86) was associated with decreased 1-year mortality.<br />Conclusion: Low maternal education and multiple birth may be linked to congenital diaphragmatic hernia. The trends in prevalence, epidemiologic correlates, and predictors of early survival can differ between congenital diaphragmatic hernia subtypes-isolated, multiple, and chromosomal.© 2018 Wiley Periodicals, Inc. © 2018 Wiley Periodicals, Inc.<br /> (© 2018 Wiley Periodicals, Inc.)
- Subjects :
- Abnormalities, Multiple epidemiology
Cohort Studies
Female
Florida
Humans
Infant
Infant Mortality
Infant, Newborn
Kaplan-Meier Estimate
Live Birth
Male
Maternal Age
Pregnancy
Pregnancy Outcome epidemiology
Prevalence
Proportional Hazards Models
Registries
Retrospective Studies
Hernias, Diaphragmatic, Congenital epidemiology
Hernias, Diaphragmatic, Congenital mortality
Subjects
Details
- Language :
- English
- ISSN :
- 2472-1727
- Volume :
- 110
- Issue :
- 14
- Database :
- MEDLINE
- Journal :
- Birth defects research
- Publication Type :
- Academic Journal
- Accession number :
- 30079599
- Full Text :
- https://doi.org/10.1002/bdr2.1357