Research: The grading of stomach position for postnatal outcomes in isolated left-sided congenital diaphragmatic hernia : A systematic review and meta-analysis

Prenat Diagn

. 2023 May 9.

 doi: 10.1002/pd.6383. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/37160690/

The grading of stomach position for postnatal outcomes in isolated left-sided congenital diaphragmatic hernia : A systematic review and meta-analysis

M D Chenxiao Hou 1Jingjing Wang 1Shijing Song 1Qingqing Wu 1

Affiliations expand

Abstract

Objectives: To evaluate the correlation between stomach position grading and postnatal outcomes in fetuses with isolated left-sided congenital diaphragmatic hernias (CDHs).

Methods: A literature search was conducted using the PubMed, Embase, and Cochrane Library database. The corresponding 95% CIs were used to assess the differences in the odds of mortality, according to the stomach position (SP) graded as level 0 to level 3. To evaluate the reliability of our results, a sensitivity analysis was also conducted.

Results: Nine papers with a total of 542 fetuses with isolated left-sided CDH were included. CDH pregnancies complicated by an intrathoracic stomach had higher odds of neonatal mortality when compared to intraabdominal stomach (odds ratio [OR] 2.86; 95% CI 1.38-5.94). Four papers with SP grading from level 0 to level 3 were included in a subgroup analysis. SP at level 1 and level 2 had lower odds of neonatal mortality when separately compared to level 3 (OR 0.12; 95% CI 0.04-0.33), (OR 0.30; 95% CI 0.16-0.54). SP at level 1 had lower odds of neonatal mortality when compared to level 2+3 (OR 0.25; 95% CI 0.09-0.66).

Conclusion: Survival of fetuses with isolated left-sided CDH is correlated with the stomach position. This article is protected by copyright. All rights reserved.

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