Prenat Diagn. 2020 Apr 12. doi: 10.1002/pd.5706. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/32279384

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

Pinton A^1,2, Boubnova J³, Becmeur F⁴, Kuhn P^5,6, Senat MV^7,8, Stirnemann J^9,10, Capelle V³, Rosenblatt J¹¹, Massardier J^12,13, Vaast P¹⁴, Gwenaelle LB^15,16, Desrumaux A¹⁷, Connant L¹⁸, Begue L¹⁹, Parmentier B²⁰, Perrotin F^21,22, Alain D²³, Benoist G^24,25, Muszynski C²⁶, Scalabre A²⁷, Winer N^28,29, Michel JL³⁰, Casagrandre-Magne F³¹, Jouannic JM^32,33, Gallot D³⁴, Mazeau PC³⁵, Sapin E³⁶, Maatouk A³⁷, Saliou AH³⁸, Sentilhes L³⁹, Biquard F⁴⁰, Mottet N⁴¹, Favre R⁴², Benachi A^43,44, Sananès N^45,46.

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Abstract

OBJECTIVES:

The objective of this study was to assess whether the laterality of CDH was a prognostic factor for neonatal survival.

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.

RESULTS:

A total of 506 CDH were include with 67 (13%) right CDH and 439 left CDH (87%). Rate of survival was 49% for right CDH and 74% for left CDH (P < 0.01). Multivariate analysis showed two factors significantly associated with mortality: thoracic herniation of liver (OR 2.27; IC 95% [1.07-4.76]; P = 0,03) and lung-to-head-ratio over under expected (OR 2.99; IC 95% [1.41-6.36]; P < 0.01). Side of CDH was not significantly associated with mortality (OR 1.87; IC 95% [0.61-5.51], P = 0.26).

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. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.PMID: 32279384 DOI: 10.1002/pd.5706