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Prenat Diagn ; 40(8): 949-957, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32279384

RESUMO

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.


Assuntos
Hérnias Diafragmáticas Congênitas/diagnóstico , Hérnias Diafragmáticas Congênitas/patologia , Pulmão/patologia , Adulto , Estudos de Coortes , Feminino , França/epidemiologia , Hérnias Diafragmáticas Congênitas/mortalidade , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Pulmão/diagnóstico por imagem , Masculino , Gravidez , Diagnóstico Pré-Natal , Prognóstico , Reprodutibilidade dos Testes , Estudos Retrospectivos
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