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Research: Predictive value of gestational age at diagnosis for outcomes in prenatally diagnosed congenital diaphragmatic hernia.

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Research: Predictive value of gestational age at diagnosis for outcomes in prenatally diagnosed congenital diaphragmatic hernia.

J Matern Fetal Neonatal Med. 2019 Sep 16:1-6. doi: 10.1080/14767058.2019.1664464. [Epub ahead of print]

Predictive value of gestational age at diagnosis for outcomes in prenatally diagnosed congenital diaphragmatic hernia.

Wang W1Pan W1Wang J1Xie W2Liu M3Wang L4Jiang Y1.

https://www.ncbi.nlm.nih.gov/pubmed/31522571

Author information

1Department of Pediatric Surgery, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China.2Department of Pediatric Surgery, Intensive Care Unit, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China.3Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China.4Department of Obstetrics, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine , Shanghai , China.

Abstract

Objective: To assess the value and accuracy of gestational age at diagnosis in predicting postnatal outcomes of prenatally diagnosed congenital diaphragmatic hernia (CDH). Study design: The medical records of 158 prenatally diagnosed neonates with CDH from 2008 to 2018 were retrospectively reviewed. Data were analyzed using parametric and nonparametric tests, appropriately. Results: Gestational age at diagnosis predicted postnatal survival independently. Survival rate at discharge increased when gestational age at diagnosis increased (p < .001). Area under the receiver operator curve for survival for gestational age at diagnosis was 0.74, observed-to-expected lung to head ratio 0.74, and liver herniation 0.76. Patients diagnosed with CDH before 25 gestational weeks had a larger size of the diaphragmatic defect, more need for patch repair, longer duration of mechanical ventilation and hospital stay than those after 25 gestational weeks. Conclusions: Gestational age at diagnosis is an independent predictor of CDH prognosis. It has a similar ability to predict survival compared to observed-to-expected lung to head ratio and liver herniation.

KEYWORDS:

Congenital diaphragmatic hernia; gestational age at diagnosis; gestational week; prognosis; survivalPMID: 31522571 DOI: 10.1080/14767058.2019.1664464

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