Observed-to-expected MRI fetal lung volume can predict long-term lung morbidity in infants with congenital diaphragmatic hernia

Abstract

Objective: Congenital diaphragmatic hernia (CDH) causes pulmonary hypoplasia and pulmonary hypertension, which are associated with long-term respiratory problems in infants. The aim of this study was to establish a marker for predicting lung function at 1 year of age in infants with CDH.

Materials and methods: Infants with isolated CDH who were delivered after 35 weeks of gestation from April 2008 to June 2016 at Nagoya University Hospital were registered. Regarding alive infants with CDH, only those who underwent follow-up for at least 1 year were registered. Finally, 48 infants were analyzed in this study.

Results: Gestational age at diagnosis, amniotic lamellar body count at birth, observed-to-expected MRI fetal lung volume (percent FLV), liver herniation, and polyhydramnios were found to be significant parameters for predicting mortality in infants with CDH. Regarding alive infants with CDH, percent FLV was the only significant parameter to predict need for oxygen therapy at 1 year of age (p < .05). There was a significant negative correlation between percent FLV and duration of oxygen therapy in infants with CDH (r = .516, p < .001).

Conclusions: Percent FLV is a useful predictor of long-term lung morbidity in infants with CDH.

Keywords:

• Congenital diaphragmatic hernia
• fetal lung volume
• lung hypoplasia
• morbidity
• MRI

Acknowledgements

We would like to thank Editage (www.editage.jp) for English language editing.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.