Neonatal outcome of preterm infants with antenatally diagnosed congenital diaphragmatic hernia: A single center’s experience

Purpose: This study aimed to determine the impact of GA cut-off on the clinical outcome of CDH and assess whether prematurity influences the predictive value of fetal lung volume measurement. Methods We investigated the medical records of infants with CDH between January 2014 and August 2021. We classified the patients into term CDH (TCDH) and preterm CDH (PCDH) groups and compared their clinical characteristics, including fetal lung volume measured by the observed-to-expected lung-to-head ratio (O/E LHR). Results Among 145 infants with CDH, 23 (15.9%) were preterm. Mean O/E LHR was significantly higher in survivors than in non-survivors with no difference between TCDH and PCDH groups. Mortality rate was significantly higher in infants with GA < 34 weeks (80%) than in late preterm infants (16.7%). O/E LHR, rather than GA < 34 weeks, was a risk factor predicting mortality in multivariate analyses. Predictive power of O/E LHR was high in the TCDH and PCDH groups, respectively. The incidence of chronic lung disease did not differ between PCDH and TCDH. Conclusion O/E LHR significantly predicted mortality in preterm infants, suggesting preterm birth alone should not be the determinant of early CDH treatment strategy.