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. 2020 Jul;40(8):949-957.
doi: 10.1002/pd.5706. Epub 2020 May 8.

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

Anne Pinton  1   2 , Julia Boubnova  3 , François Becmeur  4 , Pierre Kuhn  5   6 , Marie-Victoire Senat  7 , Julien Stirnemann  8   9 , Marianne Capelle  3 , Jonathan Rosenblatt  10 , Jérôme Massardier  11 , Pascal Vaast  12 , Gwenaelle Le Bouar  13 , Amélie Desrumaux  14 , Laure Connant  15 , Laetitia Begue  16 , Benoit Parmentier  17 , Franck Perrotin  18 , Alain Diguet  19 , Guillaume Benoist  20 , Charles Muszynski  21 , Aurélien Scalabre  22 , Norbert Winer  23   24 , Jean-Luc Michel  25 , Florence Casagrandre-Magne  26 , Jean-Marie Jouannic  27   28 , Denis Gallot  29 , Perrine Coste Mazeau  30 , Emmanuel Sapin  31 , Alexis Maatouk  32 , Anne-Hélène Saliou  33 , Loïc Sentilhes  34 , Florence Biquard  35 , Nicolas Mottet  36 , Romain Favre  37 , Alexandra Benachi  38 , Nicolas Sananès  39   40
Affiliations

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

Anne Pinton et al. Prenat Diagn. 2020 Jul.

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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References

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