J Perinatol

. 2025 Feb 21.

 doi: 10.1038/s41372-025-02226-z. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/39984718/

Golden hour management of infants with congenital diaphragmatic hernia: 15 year experience at a high-volume center

K Taylor Wild ^1 2, Holly L Hedrick ^3 4, Natalie E Rintoul ^5 3, Anne M Ades ^5 3, Juliana S Gebb ³, Leny Mathew ³, Tom Reynolds ³, Anna Bostwick ³, Elizabeth Eppley ³, Sabrina Flohr ³, N Scott Adzick ^3 4, Elizabeth E Foglia ^5 3

Affiliations Expand

• PMID: 39984718
• DOI: 10.1038/s41372-025-02226-z

Abstract

Objective: To review the evolution of golden hour management and outcomes for infants with congenital diaphragmatic hernia (CDH).

Study design: Retrospective single center cohort study of infants with CDH born 2008-2023 at a quaternary children’s hospital. Infants were grouped into 3 epochs: 2008-2013, 2014-2018, and 2019-2023. Outcome measures included extracorporeal membrane oxygenation therapy and survival.

Result: There were 454 infants, including 106 (2008-2013), 156 (2014-2018), and 192 (2019-2023). Despite increased disease severity, survival improved over time, from 71% (2008-2013) to 82% (2014-2018) and 83% (2019-2023), p = 0.02 for trend, with no difference in ECMO utilization.

Conclusion: Management of infants with CDH continues to evolve with ongoing experience at our high-volume center. Despite increasing severity of illness, survival outcomes have improved over time. In the absence of clinical trial data, observational data should be evaluated rigorously to inform care in a data-driven manner.

© 2025. The Author(s).

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