Outcomes of Congenital Diaphragmatic Hernia among Preterm Infants: Inverse Probability of Treatment Weighting Analysis

Abstract Objectives To evaluate the survival and intact-survival rates among preterm infants with congenital diaphragm hernia (CDH). Study Design Multicenter retrospective cohort study of 849 infants born between 2006 and 2020 at 15 Japanese CDH study group facilities. Multivariate logistic regression analysis adjusted using inverse probability treatment weighting (IPTW) method was used. We also compare trends of intact-survival rates among term and preterm infants with CDH. Results After adjusting using the IPTW method for CDH severity, sex, APGAR score at 5 min, and cesarean delivery, preterm infants had a significantly lower survival rate [odds ratio (OR), 0.46; 95% confidence interval (CI), 0.22–0.95] and lower intact-survival rate [OR, 0.48; 95% CI, 0.32–0.74] compared with term infants. Trends of intact-survival rates for preterm infants had changed little unlike term infants. Conclusion Prematurity was a significant risk factor for survival and intact-survival among infants with CDH, regardless of adjustment for CDH severity.