J Perinatol

. 2023 Apr 13.

 doi: 10.1038/s41372-023-01647-y. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/37055479/

Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis

Yousuke Imanishi ¹, Noriaki Usui ², Taizo Furukawa ³, Kouji Nagata ⁴, Masahiro Hayakawa ⁵, Shoichiro Amari ⁶, Akiko Yokoi ⁷, Kouji Masumoto ⁸, Masaya Yamoto ⁹, Tadaharu Okazaki ¹⁰, Noboru Inamura ¹¹, Katsuaki Toyoshima ¹², Keita Terui ¹³, Hiroomi Okuyama ¹⁴

Affiliations expand

• PMID: 37055479
• DOI: 10.1038/s41372-023-01647-y

Abstract

Objectives: To evaluate the survival and intact-survival rates among preterm infants with congenital diaphragm hernia (CDH).

Study design: Multicenter retrospective cohort study of 849 infants born between 2006 and 2020 at 15 Japanese CDH study group facilities. Multivariate logistic regression analysis adjusted using inverse probability treatment weighting (IPTW) method was used. We also compare trends of intact-survival rates among term and preterm infants with CDH.

Results: After adjusting using the IPTW method for CDH severity, sex, APGAR score at 5 min, and cesarean delivery, gestational age and survival rates have a significantly positive correlation [coefficient of determination (COEF) 3.40, 95% confidence interval (CI), 1.58-5.21, p value <0.001] and higher intact-survival rate [COEF 2.39, 95% CI, 1.73-4.06, p value 0.005]. Trends of intact-survival rates for both preterm and term infants had significantly changed, but improvement in preterm infants was much smaller than in term infants.

Conclusion: Prematurity was a significant risk factor for survival and intact-survival among infants with CDH, regardless of adjustment for CDH severity.

© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.