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Image-based prenatal predictors correlate with postnatal survival, extracorporeal life support use, and defect size in left congenital diaphragmatic hernia

Journal of Perinatology volume 42, pages 1195–1201 (2022)Cite this article

Subjects

Abstract

Objective

To evaluate the association between prenatal imaging predictors of patients with left-sided congenital diaphragmatic hernia (LCDH) and postnatal outcomes.

Study design

CDH study group data were reviewed for LCDH infants born 2015–2019. Prenatal ultrasound (US) and magnetic resonance imaging (MRI) data were collected and correlated with postnatal information including CDHSG defect size (A through D or non-repair (NR)).

Results

In total, 929 LCDH patients were included. Both US and MRI imaging predictors correlated with postnatal survival (72.2%) and ECLS use (29.6%). Logistic regression models confirmed increased survival and decreased ECLS use with larger values for all predictors. Importantly, all prenatal values evaluated showed no significant difference between defect size D and NR patients.

Conclusions

This is the largest cohort of LCDH patients and demonstrates that prenatal imaging factors correlate with postnatal outcomes and confirms that patients in the non-repair group are prenatally similar to type D defects.

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Fig. 1
Fig. 2: Survival and ECLS utilization.
Fig. 3: Logistic regression models.

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Data availability

The data that supports the findings of this study are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Michigan Medicine, Department of Surgery, Section of Pediatric Surgery, Fetal Diagnosis and Treatment Center, University of Michigan, Ann Arbor, MI, USA

    Erin E. Perrone, Monita Karmakar & George B. Mychaliska

  2. Department of Pediatric Surgery, McGovern Medical School at UTHealth and Children’s Memorial Hermann Hospital, Houston, TX, USA

    Pamela A. Lally, Matthew T. Harting & Kevin P. Lally

  3. Department of Primary Care and Population Health, Stanford University, Palo Alto, CA, USA

    Sukyung Chung

  4. Department of Neonatology and Pediatric Intensive Care Children’s Hospital, University of Bonn, Bonn, Germany

    Florian Kipfmueller

  5. Neonatal Surgical Unit, Ospedale Pediatrico Bambino Gesu, IRCCS, Medical and Surgical Department of the Fetus, Newborn, and Infant, Rome, Italy

    Francesco Morini

  6. Department of Surgery, Division of Pediatric Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Ryan Phillips

  7. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital Stanford, Palo Alto, CA, USA

    Krisa P. Van Meurs

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  1. Erin E. Perrone
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  11. Kevin P. Lally
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Consortia

The Congenital Diaphragmatic Hernia Study Group

Contributions

Study conception and design: EEP, PAL, MTH, GBM, and KPL; Data acquisition: PAL; Analysis and data interpretation: EEP, MK, and SC; Drafting of the manuscript: EEP, MK, and MTH; Critical revision: PAL, FK, FM, RP, KPVM, MTH, GBM, and KPL.

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Correspondence to Erin E. Perrone.

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Perrone, E.E., Karmakar, M., Lally, P.A. et al. Image-based prenatal predictors correlate with postnatal survival, extracorporeal life support use, and defect size in left congenital diaphragmatic hernia. J Perinatol 42, 1195–1201 (2022). https://doi.org/10.1038/s41372-022-01357-x

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