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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 2 Denis Gallot 27, 28 Perrine Coste Mazeau 29 Emmanuel Sapin 30 Alexis Maatouk 31, 32 Anne‐hélène Saliou 33 Loïc Sentilhes 34, 35 Florence Biquard 34 Nicolas Mottet 36 Romain Favre 37, 38 Alexandra Benachi 39 Nicolas Sananès 40, 38
* Auteur correspondant
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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https://hal-univ-bourgogne.archives-ouvertes.fr/hal-02615464
Contributeur : Le2i - Université de Bourgogne <>
Soumis le : vendredi 22 mai 2020 - 18:22:51
Dernière modification le : mercredi 14 octobre 2020 - 04:06:54

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Anne Pinton, Julia Boubnova, François Becmeur, Pierre Kuhn, Marie‐victoire Senat, et al.. Is laterality of congenital diaphragmatic hernia a reliable prognostic factor? French national cohort study. Prenatal Diagnosis, Wiley, 2020, ⟨10.1002/pd.5706⟩. ⟨hal-02615464⟩

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