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

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
• survival

Acknowledgments

We would like to thank Shourong Huang for collecting the data.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was funded by School of Medicine, Shanghai Jiao Tong University [JQ201708].