Multicenter Study

. 2023 Jul;43(7):884-888.

doi: 10.1038/s41372-023-01647-y. Epub 2023 Apr 13.

Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis

Affiliations

¹ Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan. rasheed0421@yahoo.co.jp.
² Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.
³ Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
⁴ Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁵ Division of Neonatology, Center for Maternal‑Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
⁶ Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan.
⁷ Department of Pediatric Surgery, Kobe Children's Hospital, Kobe, Japan.
⁸ Department of Pediatric Surgery, Tsukuba University, Tsukuba, Japan.
⁹ Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
¹⁰ Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
¹¹ Department of Pediatrics, Kinki University, Higashiosaka, Japan.
¹² Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
¹³ Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
¹⁴ Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

PMID: 37055479
DOI: 10.1038/s41372-023-01647-y

Multicenter Study

Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis

Yousuke Imanishi et al. J Perinatol. 2023 Jul.

. 2023 Jul;43(7):884-888.

doi: 10.1038/s41372-023-01647-y. Epub 2023 Apr 13.

Authors

Affiliations

¹ Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Japan. rasheed0421@yahoo.co.jp.
² Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan.
³ Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
⁴ Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁵ Division of Neonatology, Center for Maternal‑Neonatal Care, Nagoya University Hospital, Nagoya, Japan.
⁶ Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan.
⁷ Department of Pediatric Surgery, Kobe Children's Hospital, Kobe, Japan.
⁸ Department of Pediatric Surgery, Tsukuba University, Tsukuba, Japan.
⁹ Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
¹⁰ Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
¹¹ Department of Pediatrics, Kinki University, Higashiosaka, Japan.
¹² Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Kanagawa, Japan.
¹³ Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
¹⁴ Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.

PMID: 37055479
DOI: 10.1038/s41372-023-01647-y

Abstract

Objectives: To evaluate the survival and intact-survival rates among preterm infants with congenital diaphragm hernia (CDH).

Study design: Multicenter retrospective cohort study of 849 infants born between 2006 and 2020 at 15 Japanese CDH study group facilities. Multivariate logistic regression analysis adjusted using inverse probability treatment weighting (IPTW) method was used. We also compare trends of intact-survival rates among term and preterm infants with CDH.

Results: After adjusting using the IPTW method for CDH severity, sex, APGAR score at 5 min, and cesarean delivery, gestational age and survival rates have a significantly positive correlation [coefficient of determination (COEF) 3.40, 95% confidence interval (CI), 1.58-5.21, p value <0.001] and higher intact-survival rate [COEF 2.39, 95% CI, 1.73-4.06, p value 0.005]. Trends of intact-survival rates for both preterm and term infants had significantly changed, but improvement in preterm infants was much smaller than in term infants.

Conclusion: Prematurity was a significant risk factor for survival and intact-survival among infants with CDH, regardless of adjustment for CDH severity.

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Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis

Affiliations

Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis

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