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Predictors of survival in children born with congenital diaphragmatic hernia: a registry-based study

Lookup NU author(s): Dr Rute Velosa Vieira, Professor Judith Rankin

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Abstract

Background: Congenital diaphragmatic hernia (CDH) is a severe congenitalanomaly associated with high neonatal mortality. This study aims to evaluatethe predictors for survival in infants born with CDH. Methods: A cohortstudy of prospectively collected data on all liveborn infants with CDH notifiedto the population-based UK Northern Congenital Abnormality Survey(NorCAS), and delivered between 01 Jan 1985 and 31 Dec 2003, matched tohospital and national mortality records to 29 Jan 2008. Survival to 20 yearswas estimated using Kaplan-Meier methods. Multiple logistic regression wasused to identify overall predictors of mortality while Royston-Parmar survivalmodels were used to examine predictors of survival at 1-week and 1-month within the children that died. Results: There were 246 CDH singletoninfants notified to NorCAS during the study period, a total prevalence of 3.8(95% CI: 3.3,4.3) CDH cases per 10,000 pregnancies. Of these, 18.3%resulted in termination of pregnancy, 7.3% in spontaneous fetal loss (miscarriage20 weeks and stillbirth) and 74.4% in live births. Forty-seven percentof the live births resulted in death. Year of birth (per year; OR=0.88;95% CI: 0.82, 0.95; p<0.001), birth weight (per 100g; OR50.92; 95% CI: 0.86,0.98; p50.007), most deprived (compared to moderately deprived; OR52.98;95% CI: 1.28, 6.92; p50.01), prenatal diagnosis (OR55.0; 95% CI: 2.17, 11.4;p<0.001) and presence of other congenital anomalies (OR55.3; 95% CI: 1.46,18.7; p50.01) were significant predictors of mortality. Within the children thatdied, year of birth (per year; Hazard Ratio (HR)50.95; 95% CI: 0.91, 0.99;p<0.001) was the only significant predictor of survival at 1-week and 1-month.Conclusions: Identifying predictors of survival is important for prenatal counsellingof parents whose pregnancy is affected by CDH and for health care planningfor the future care needs of affected children.


Publication metadata

Author(s): Vieira R, Rankin J

Editor(s): Rankin J

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: 13th EUROCAT Scientific Symposium: Advancing congenital anomaly research through collaboration

Year of Conference: 2016

Pages: 503-503

Print publication date: 14/06/2016

Online publication date: 14/06/2016

Acceptance date: 14/06/2016

ISSN: 1542-0760

Publisher: John Wiley & Sons, Inc.

URL: http://dx.doi.org/10.1002/bdra.23536

DOI: 10.1002/bdra.23536

Series Title: Birth Defects Research Part A: Clinical and Molecular Teratology


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