Research: Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia

J Clin Med

. 2023 Feb 14;12(4):1508.

 doi: 10.3390/jcm12041508.

Fetal Lung Volume Appears to Predict Respiratory Morbidity in Congenital Diaphragmatic Hernia

Valentine Cerbelle 1Kévin Le Duc 2 3Stephanie Lejeune 1Sébastien Mur 3Héloise Lerisson 4Elodie Drumez 5Rony Sfeir 6Julien Bigot 4 7 8Pauline Verpillat 4Riadh Boukhris 3Pascal Vaast 9Clémence Mordacq 1Caroline Thumerelle 1Laurent Storme 2 3Antoine Deschildre 1Center For Rare Disease Congenital Diaphragmatic Hernia

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Free PMC article


Congenital diaphragmatic hernia (CDH) is associated with pulmonary hypoplasia and respiratory morbidity. To assess whether respiratory morbidity during the first 2 years of life in infants with left-sided CDH is associated with fetal lung volume (FLV) evaluated by the observed-to-expected FLV ratio (o/e FLV) on antenatal magnetic resonance imaging (MRI). In this retrospective study, o/e FLV measures were collected. Respiratory morbidity in the first 2 years of life was studied according to two endpoints: treatment with inhaled corticosteroids for >3 consecutive months and hospitalization for any acute respiratory disease. The primary outcome was a favorable progression defined by the absence of either endpoint. Forty-seven patients were included. The median o/e FLV was 39% (interquartile range, 33-49). Sixteen (34%) infants were treated with inhaled corticosteroids and 13 (28%) were hospitalized. The most efficient threshold for a favorable outcome was an o/e FLV ≥ 44% with a sensitivity of 57%, specificity of 79%, negative predictive value of 56%, and positive predictive value of 80%. An o/e FLV ≥ 44% was associated with a favorable outcome in 80% of cases. These data suggest that lung volume measurement on fetal MRI may help to identify children at lower respiratory risk and improve information during pregnancy, patient characterization, decisions about treatment strategy and research, and personalized follow-up.

Keywords: antenatal diagnosis; child; congenital diaphragmatic hernia; fetal lung volume; fetal magnetic resonance imaging; prognostic factor; respiratory morbidity.

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