Background: Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly associated with high neonatal mortality. This study aims to evaluate the predictors for survival in infants born with CDH. Methods: A cohort study of prospectively collected data on all liveborn infants with CDH notified to the population-based UK Northern Congenital Abnormality Survey (NorCAS), and delivered between 01-Jan-1985 and 31-Dec-2003, matched to hospital and national mortality records to 29-Jan-2008. Survival to 20 years was estimated using Kaplan-Meier methods. Multiple logistic regression was used to identify overall predictors of mortality while Royston-Parmar survival models were used to examine predictors of survival at 1-week and 1-month within the children that died. Results: There were 246 CDH singleton infants notified to NorCAS during the study period, a total prevalence of 3.8 (95%CI:3.3,4.3) CDH cases per 10,000 pregnancies. Of these, 18.3% resulted in termination of pregnancy, 7.3% in spontaneous fetal loss (miscarriage≥20 weeks and stillbirth) and 74.4% in live births. Forty-seven percent of the live births resulted in death. Year of birth (per year; OR=0.88;95%CI:0.82,0.95;p<0.001), birth weight (per 100g;OR=0.92;95%CI:0.86,0.98; p=0.007), most deprived (compared to moderately deprived;OR=2.98;95%CI:1.28,6.92;p=0.01), prenatal diagnosis (OR=5.0;95%CI:2.17,11.4;p<0.001) and presence of other congenital anomalies (OR=5.3;95%CI:1.46,18.7;p=0.01) were significant predictors of mortality. Within the children that died, year of birth (per year; Hazard Ratio(HR)=0.95;95%CI:0.91,0.99;p<0.001) was the only significant predictor of survival at 1-week and 1-month. Conclusions: Identifying predictors of survival is important for prenatal counselling of parents whose pregnancy is affected by CDH and for health care planning for the future care needs of affected children.
|Journal||Birth Defects Research Part A: Clinical and Molecular Teratology|
|Publication status||Published - 2016|
|Event||EUROCAT Scientific Symposium 2016 - Milan, Italy|
Duration: 16 Jun 2016 → …