[Prognostic factors associated with mortality in newborns with congenital diaphragmatic hernia].

UNLABELLED

The objective was to identify prognostic factors associated with mortality in newborns with congenital diaphragmatic hernia.

METHODS

Study design was cases and controls nested in a cohort. We studied 65 newborns. Variables analyzed included gestational age, birth weight, Apgar and Silverman scores, surgery timing, presence of pneumothorax, degree of pulmonary hypoplasia, persistent pulmonary hypertension, mean airway pressure, blood gas analysis, ventilatory indexes, and risk of death score at admission.

RESULTS

Median gestational age was 38 weeks and median birth weight was 2,975 g. Lung hypoplasia ranged from 20-95%. Mortality was 40%; its main cause was persistent pulmonary hypertension. In multivariate analysis significant prognostic factors were risk of death > 50% (ORa = 59, 95% Confidence interval [CI] = 9.6-361) and mean airway pressure > 13 (ORa = 6, 95% CI = 1.2-29).

CONCLUSIONS

Factors that influence prognosis of newborns with congenital diaphragmatic hernia are related with ventilation process as well as mortality risk score at admission to neonatal intensive care unit.