[Prognostic factors associated with mortality in newborns with congenital diaphragmatic hernia]. 2003

Heladia J-García, and Silvia Aparicio-de la Luz, and Mario Franco-Gutiérrez, and David González-Lara, and Héctor González-Cabello, and Raúl Villegas-Silva
Unidad de Cuidados Intensivos Neonatales, Hospital de Pediatría, CMN Siglo XXI, IMSS, Av. Cuauhtémoc 330, Col. Doctores, México, D.F. CP. 06725. hely1802@yahoo.com.mx

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.

UI MeSH Term Description Entries
D007226 Infant Mortality Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth. Neonatal Mortality,Mortality, Infant,Postneonatal Mortality,Infant Mortalities,Mortalities, Infant,Mortalities, Neonatal,Mortalities, Postneonatal,Mortality, Neonatal,Mortality, Postneonatal,Neonatal Mortalities,Postneonatal Mortalities
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008297 Male Males
D010547 Persistent Fetal Circulation Syndrome A syndrome of persistent PULMONARY HYPERTENSION in the newborn infant (INFANT, NEWBORN) without demonstrable HEART DISEASES. This neonatal condition can be caused by severe pulmonary vasoconstriction (reactive type), hypertrophy of pulmonary arterial muscle (hypertrophic type), or abnormally developed pulmonary arterioles (hypoplastic type). The newborn patient exhibits CYANOSIS and ACIDOSIS due to the persistence of fetal circulatory pattern of right-to-left shunting of blood through a patent ductus arteriosus (DUCTUS ARTERIOSUS, PATENT) and at times a patent foramen ovale (FORAMEN OVALE, PATENT). Fetal Circulation, Persistent,Hypertension, Pulmonary, of Newborn, Persistent,Persistent Pulmonary Hypertension of Newborn,ACD-MPV,ACDMPV,Alveolar Capillary Dysplasia With Misalignment Of Pulmonary Veins,Alveolar Capillary Dysplasia With Misalignment Of Pulmonary Veins And Other Congenital Anomalies,Circulation, Persistent Fetal,Familial Persistent Pulmonary Hypertension of the Newborn,Misalignment of the Pulmonary Vessels,Persistent Fetal Circulation,Pulmonary Hypertension, Familial Persistent, of the Newborn,ACD MPV
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D012123 Pulmonary Ventilation The total volume of gas inspired or expired per unit of time, usually measured in liters per minute. Respiratory Airflow,Ventilation Tests,Ventilation, Pulmonary,Expiratory Airflow,Airflow, Expiratory,Airflow, Respiratory,Test, Ventilation,Tests, Ventilation,Ventilation Test
D001724 Birth Weight The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms. Birthweight,Birth Weights,Birthweights,Weight, Birth,Weights, Birth
D005260 Female Females
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages

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