Article Text

PERINATAL RISK FACTORS AND MORTALITY IN CONGENITAL DIAPHRAGMATIC HERNIA (CDH) INFANTS
  1. I Capolupo1,
  2. A Conforti1,
  3. M P Ronchetti1,
  4. F Morini1,
  5. P Bagolan1,
  6. C Corchia1
  1. 1Department of Medical and Surgical Neonatology, Bambino Gesu Children’s Hospital, Rome, Italy

Abstract

Background Since the introduction of new therapeutic approaches, the survival rate in CDH infants has dramatically increased, however mortality is still reported up to 40%. Aim of our study is to evaluate the role of different perinatal risk factors, possibly related to higher mortality rate.

Patients and Methods All patients treated for CDH between 2000 and 2007 were included. Risk factors evaluated were gestational age (<37 vs. ⩾37 wks), birth weight (<2500 vs. ⩾2500 gr), associated cardiac abnormalities, liver in the chest, pulmonary hypertension and the diaphragmatic defect size (patch repair needed). Statistical analysis was performed Fisher exact test and calculation of relative risk (RR).

Results Overall mortality rate was 35%, 38 newborns died before surgery and 12 after operation. Table summarized the results.

Conclusion In our population all risk factors considered were significantly associated with a higher mortality. The need of patch repair was the most predictive factor for patients died after surgery. The identification of risk factors highly related to worse survival rate is a primary goal to better understand the patho-physiology of CDH and to improve the care given.

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