Abstract
Objective
To evaluate the clinical profile and predictors of mortality in neonates with congenital diaphragmatic hernia (CDH).
Method
Demographic and clinical parameters of neonates with congenital diaphragmatic heria (n=37) between January 2014 and October, 2017 were reviewed, and compared among those who survived or expired in hospital.
Result
Median (range) gestation and birthweight were 38 (37–39) weeks and 2496 (2044–2889) g, respectively. Persistent pulmonary hypertension (PPHN) was documented in 19 (51%) neonates and 10 (27%) had associated malformations. Surgery could be performed in 18 (49%), overall mortality was 60%. On univariate analysis, low Apgar scores, presence of malformations, PPHN, need for higher initial peak inspiratory pressure/high frequency ventilation, and requirement of a patch for closure were associated with increased mortality. On multivariate analysis, PPHN remained the only significant risk factor [adjusted RR 3.74 (95% CI 1.45–9.68)].
Conclusion
The survival of infants with CDH is low, and PPHN is an important predictor of mortality.
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Contributors: TS: developed study proforma, collected data and wrote the first draft of the paper; SS: collection of data and contributed in writing the manuscript; DT: collection of data and analysis of results; AV: give important inputs in conduction of study and writing of the manuscript; AT: supervised implementation of the study and corrected the final manuscript ad reviewed; JS: data analysis and compilation, writing up the final manuscript; RA,AD: supervised the study as well as gave critical inputs in writing up the manuscript.
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Sahoo, T., Sivanandan, S., Thomas, D. et al. Predictors of Mortality among Neonates with Congenital Diaphragmatic Hernia: Experience from an Inborn Unselected Cohort in India. Indian Pediatr 56, 1037–1040 (2019). https://doi.org/10.1007/s13312-019-1687-z
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DOI: https://doi.org/10.1007/s13312-019-1687-z