Risk factors associated with death of newborn with congenital diaphragmatic hernia

Objective To investigate the risk factors of congenital diaphragmatic hernia (CDH) deaths. Methods A retrospective study was conducted on 37 CDH patients during 10 years. Clinical characteristics and risk factors were compared and non-conditional logistic regression analysis was performed to determine independent predictors for mortality. Results Twenty nine patients, from a total of 37, underwent surgery for CDH. The total mortality rate in patients with CDH was 32.4% (12/37) and the overall operative mortality was 13.8% (4/29). There was a significant difference between CDH patients who survived (n=25) and those who died (n=12) in birth weight [(3.12±0.41) kg vs (2.66±0.65) kg], the age on admission [(135.14±209.71) h vs (6.67±7.79) h], hospital length of stay [(16.52±6.23) d vs (1.25±1.38) d], oxygenation index [(239.55±115.95) mmHg vs (96.10±59.18) mmHg, 1 mmHg=0.133 kPa], early antenatal diagnosis (3 cases vs 6 cases), right congenital diaphragmatic hernia (1 cases vs 4 cases), cardiac malformations (2 cases vs 6 cases) and presence of persistent pulmonary hypertension of newborn (3 cases vs 7 cases) (P<0.05). Using logistic regression analysis, the following factors independently predicted mortality were antenatal diagnosis (OR=20.97, 95%CI 1.60~275.78), low oxygenation index (OR=18.12, 95%CI 0.80~123.12) and cardiac malformations (OR=22.0, 95%CI 1.46~332.32). Conclusion CDH patients have higher mortality. Risk factors for mortality in neonatal CDH are associated with early antenatal diagnosis, low oxygenation index and cardiac malformations. Key words: Congenital diaphragmatic hernia; Risk factors; Mortality; Infant, newborn