Prematurity and fetal lung response after tracheal occlusion in fetuses with severe congenital diaphragmatic hernia.
J Matern Fetal Neonatal Med
; 29(18): 3030-4, 2016 Sep.
Article
in En
| MEDLINE
| ID: mdl-26633729
ABSTRACT
OBJECTIVE:
To evaluate the independent association of fetal pulmonary response and prematurity to postnatal outcomes after fetal tracheal occlusion for congenital diaphragmatic hernia.METHODS:
Fetal pulmonary response, prematurity (<37 weeks at delivery) and extreme prematurity (<32 weeks at delivery) were evaluated and compared between survivors and non-survivors at 6 months of life. Multivariable analysis was conducted with generalized linear mixed models for variables significantly associated with survival in univariate analysis.RESULTS:
Eighty-four infants were included, of whom 40 survived (47.6%) and 44 died (52.4%). Univariate analysis demonstrated that survival was associated with greater lung response (p=0.006), and the absence of extreme preterm delivery (p=0.044). In multivariable analysis, greater pulmonary response after FETO was an independent predictor of survival (aOR 1.87, 95% CI 1.08-3.33, p=0.023), whereas the presence of extreme prematurity was not statistically associated with mortality after controlling for fetal pulmonary response (aOR 0.52, 95% CI 0.12-2.30, p=0.367).CONCLUSION:
Fetal pulmonary response after FETO is the most important factor associated with survival, independently from the gestational age at delivery.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Gestational Age
/
Fetal Diseases
/
Fetoscopy
/
Hernias, Diaphragmatic, Congenital
/
Infant, Premature, Diseases
/
Lung
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Newborn
Language:
En
Journal:
J Matern Fetal Neonatal Med
Journal subject:
OBSTETRICIA
/
PERINATOLOGIA
Year:
2016
Document type:
Article
Affiliation country:
Estados Unidos