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Is laterality of congenital diaphragmatic hernia a reliable prognostic factor? French national cohort study.

Authors :
Pinton A
Boubnova J
Becmeur F
Kuhn P
Senat MV
Stirnemann J
Capelle M
Rosenblatt J
Massardier J
Vaast P
Le Bouar G
Desrumaux A
Connant L
Begue L
Parmentier B
Perrotin F
Diguet A
Benoist G
Muszynski C
Scalabre A
Winer N
Michel JL
Casagrandre-Magne F
Jouannic JM
Gallot D
Coste Mazeau P
Sapin E
Maatouk A
Saliou AH
Sentilhes L
Biquard F
Mottet N
Favre R
Benachi A
Sananès N
Source :
Prenatal diagnosis [Prenat Diagn] 2020 Jul; Vol. 40 (8), pp. 949-957. Date of Electronic Publication: 2020 May 08.
Publication Year :
2020

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.<br />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.<br />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).<br />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.<br /> (© 2020 John Wiley & Sons, Ltd.)

Details

Language :
English
ISSN :
1097-0223
Volume :
40
Issue :
8
Database :
MEDLINE
Journal :
Prenatal diagnosis
Publication Type :
Academic Journal
Accession number :
32279384
Full Text :
https://doi.org/10.1002/pd.5706