Van der Veeken Lennart, Vergote Simen, Kunpalin Yada, Kristensen Karl, Deprest Jan, Bruschettini Matteo
Department of Development and Regeneration, Cluster Woman and Child, Group Biomedical Sciences, KU Leuven University of Leuven, Leuven, Belgium.
Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
Prenat Diagn. 2022 Mar;42(3):318-329. doi: 10.1002/pd.5916. Epub 2021 Mar 21.
Congenital diaphragmatic hernia (CDH) reportedly has neurologic consequences in childhood however little is known about the impact in isolated CDH.
Herein we aimed to describe the risk of neurodevelopmental complications in children born with isolated CDH.
MATERIALS & METHODS: We systematically reviewed literature for reports on the neurological outcome of infants born with isolated CDH. The primary outcome was neurodevelopmental delay. Secondary outcomes included, motor skills, intelligence, vision, hearing, language and behavior abnormalities.
Thirteen out of 87 (15%) studies reported on isolated CDH, including 2624 out of 24,146 children. Neurodevelopmental delay was investigated in four studies and found to be present in 16% (3-34%) of children. This was mainly attributed to motor problems in 13% (2-30%), whereas cognitive dysfunction only in 5% (0-20%) and hearing in 3% (1-7%). One study assessed the effect of fetal surgery. When both isolated and non-isolated children were included, these numbers were higher.
This systematic review demonstrates that only a minority of studies focused on isolated CDH, with neurodevelopmental delay present in 16% of children born with CDH.
To accurately counsel patients, more research should focus on isolated CDH cases and examine children that underwent fetal surgery.
据报道，先天性膈疝（CDH）在儿童期会产生神经学后果，然而对于孤立性CDH的影响却知之甚少。
在此，我们旨在描述患有孤立性CDH的儿童发生神经发育并发症的风险。
我们系统回顾了关于患有孤立性CDH的婴儿神经学结局的文献报道。主要结局是神经发育迟缓。次要结局包括运动技能、智力、视力、听力、语言和行为异常。
87项研究中有13项（15%）报道了孤立性CDH，涉及24,146名儿童中的2624名。四项研究对神经发育迟缓进行了调查，发现16%（3%-34%）的儿童存在神经发育迟缓。这主要归因于13%（2%-30%）的儿童存在运动问题，而认知功能障碍仅占5%（0%-20%），听力问题占3%（1%-7%）。一项研究评估了胎儿手术的效果。当纳入孤立性和非孤立性儿童时，这些数字更高。
这项系统评价表明，只有少数研究关注孤立性CDH，16%的CDH患儿存在神经发育迟缓。
为了准确地为患者提供咨询，更多的研究应聚焦于孤立性CDH病例，并对接受胎儿手术的儿童进行检查。
