2020 · PRENATAL DIAGNOSIS

Is laterality of congenital diaphragmatic hernia a reliable prognostic factor? French national cohort study

Pinton, Anne, Boubnova, Julia, Becmeur, Francois, Kuhn, Pierre, Senat, Marie-Victoire, Stirnemann, Julien, Capelle, Marianne, Rosenblatt, Jonathan, Massardier, Jerome, Vaast, Pascal, Le Bouar, Gwenaelle, Desrumaux, Amelie, Connant, Laure, Begue, Laetitia, Parmentier, Benoit, Perrotin, Franck, Diguet, Alain, Benoist, Guillaume, Muszynski, Charles, Scalabre, Aurelien, Winer, Norbert, Michel, Jean-Luc, Casagrandre-Magne, Florence, Jouannic, Jean-Marie, Gallot, Denis, Mazeau, Perrine Coste, Sapin, Emmanuel, Maatouk, Alexis, Saliou, Anne-Helene, Sentilhes, Loic, Biquard, Florence, Mottet, Nicolas, Favre, Romain, Benachi, Alexandra, Sananes, Nicolas

Journal
PRENATAL DIAGNOSIS
Année
2020
Volume
40
Numéro
8
Pages
949-957
Mois
JUL
DOI
10.1002/pd.5706

Abstract

Objectives The objective of this study was to assess whether the laterality of congenital diaphragmatic hernia (CDH) was a prognostic factor for neonatal survival. Methods This was a cohort study using the French national database of the Reference Center for Diaphragmatic Hernias. The principal endpoint was survival after hospitalization in intensive care. We made a comparative study between right CDH and left CDH by univariate and multivariate analysis. Terminations and stillbirths were excluded from analyses of neonatal outcomes. Results A total of 506 CDH were included with 67 (13%) right CDH and 439 left CDH (87%). Rate of survival was 49% for right CDH and 74% for left CDH (P < .01). Multivariate analysis showed two factors significantly associated with mortality: thoracic herniation of liver (OR 2.27; IC 95% [1.07-4.76]; P = .03) and lung-to-head-ratio over under expected (OR 2.99; IC 95% [1.41-6.36]; P < .01). Side of CDH was not significantly associated with mortality (OR 1.87; IC 95% [0.61-5.51], P = .26). Conclusion Rate of right CDH mortality is more important than left CDH. Nevertheless after adjusting for lung-to-head-ratio and thoracic herniation of liver, right CDH does not have a higher risk of mortality than left CDH.

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