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Neonatology. 2010;98(4):370-80. doi: 10.1159/000316974. Epub 2010 Oct 30.

Risk factors for chronic lung disease and mortality in newborns with congenital diaphragmatic hernia.

Author information

1
Intensive Care and Department of Pediatric Surgery, Erasmus MC - Sophia, Rotterdam, The Netherlands.

Abstract

BACKGROUND:

Congenital diaphragmatic hernia (CDH) is associated with a mortality rate of 10-35% in live-born infants. Moreover, CDH survivors have a substantial risk of developing long-term pulmonary sequelae, such as bronchopulmonary dysplasia (BPD).

OBJECTIVES:

This study aims to evaluate risk factors associated with BPD and mortality in neonates with CDH, with particular focus on the initial ventilation mode.

METHODS:

Eligible for inclusion were live-born infants with CDH born from 2001 through 2006 at the centers participating in the CDH Study Group. BPD (defined as oxygen dependency at day 30) and/or mortality by day 30 served as the primary endpoint.

RESULTS:

A total of 2,078 neonates were included in the analysis. At day 30, 56% of the patients had either died or met the criteria for BPD. In infants who survived until day 30, the prevalence of BPD was 41%. The overall mortality rate was 31%. High-frequency oscillatory ventilation as initial ventilation mode, a right-sided defect, a prenatal diagnosis, a lower Apgar score at 5 min, a cardiac anomaly, a chromosomal anomaly and a lower gestational age were all associated with BPD and/or mortality by day 30.

CONCLUSIONS:

Despite improvements in neonatal care, the rates of BPD and early mortality in newborns with CDH are still considerable. Several important risk factors for a worse outcome are reported in this nonrandomized prospective observational study.

PMID:
21042035
DOI:
10.1159/000316974
[Indexed for MEDLINE]

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