Survival Rate Changes in Children With Congenital Diaphragmatic Hernia Over the Past Three Decades: a Nationwide, Population-based Prospective Nested Case-control Study

Abstract PURPOSE: The survival rate (SR) for neonates born with congenital diaphragmatic hernia (CDH) remains high. Our aim was to investigate how changed the SR in children with CDH over the past decades. METHODS: The study was a nationwide, population-based prospective nested case-control study within a cohort of newborn children who was born in Sweden during the observational period from 1st January 1982 until 31st December 2015. RESULTS: In the study period 4654 (99.6%) control children, and 684 children with CDH (70.4%,p<0.001) were survival at 2-years of age. Any patients who were born with CDH has overall 5,8 times higher chance for not survive 2-years of age than children without CDH. The SR improved significantly in CDH in the past 3 decades. Significantly higher number of patients were premature born in the CDH group than in the controls (23.3%vs6.1%,p<0.001). The SR of premature and non-premature born CDH patients increased significantly over the past 3 decades. CONCLUSION: The SR of CDH patients were significantly increased in the past 3 decades. Although, the 2-years survival remains 5,8 times higher than those who were not born with CDH. These changes were mainly attributed to the improved SR of premature and non-premature born CDH patients.