Biomaterial Database

Pulmonary hypertension in congenital diaphragmatic hernia: Antenatal prediction and impact on neonatal mortality. 2022

David Basurto, and Francesca Maria Russo, and Ioannis Papastefanou, and Emma Bredaki, and Karel Allegaert, and Africa Pertierra, and Anne Debeer, and Luc De Catte, and Liesbeth Lewi, and Roland Devlieger, and Paolo De Coppi, and Eduard Gratacos, and Olga Gomez, and Jan Deprest

My FetUZ Fetal Research Center, Department of Development and Regeneration, Cluster Woman and Child, Biomedical Sciences, KU Leuven, Leuven, Belgium.

To determine the prevalence of pulmonary hypertension (PAH) in left-sided congenital diaphragmatic hernia (CDH); how we could predict it; and how PAH contributed to the model for mortality prediction. Retrospective analysis in three European centers. The primary outcome was the presence of PAH on postnatal day (d) 1, 7, and at discharge. Studied predictors of PAH were: observed/expected-lung/head-ratio (o/e LHR), liver-herniation, fetoscopic endoluminal tracheal occlusion (FETO), and gestational age (GA) at delivery. The combined effect of pre- and postnatal variables on mortality was modeled by Cox regression. Of the 197 neonates, 56 (28.4%) died. At d1, 67.5% (133/197) had PAH and 61.9% (101/163) by d7. Overall, 6.4% (9/141) had PAH at discharge. At d1, o/e LHR (odds ratio (OR) 0.96) and FETO (OR 2.99) independently correlated to PAH (areas under the curve [AUC]: 0.74). At d7, PAH significantly correlated only with the use of FETO (OR 3.9; AUC: 0.65). None were significant for PAH at discharge. Combining the occurrence of PAH with antenatal biomarkers improved mortality prediction (p = 0.02), in a model including o/e LHR (HR: 0.94), FETO (HR: 0.35), liver herniation (HR: 16.78), and PAH (HR: 15.95). Antenatal prediction of PAH was only moderate. The postnatal occurrence of PAH further increases the risk of death. Whereas this may be used to counsel parents in the postnatal period, our study demonstrates there is a need to find more accurate antenatal predictors for PAH.

UI	MeSH Term	Description	Entries
D006976	Hypertension, Pulmonary	Increased VASCULAR RESISTANCE in the PULMONARY CIRCULATION, usually secondary to HEART DISEASES or LUNG DISEASES.	Pulmonary Hypertension
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
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D005260	Female		Females
D005332	Fetoscopy	Endoscopic examination, therapy or surgery of the fetus and amniotic cavity through abdominal or uterine entry.	Amnioscopic Surgical Procedures,Amnioscopy,Embryoscopic Surgical Procedures,Embryoscopy,Fetoscopic Surgical Procedures,Surgical Procedures, Amnioscopic,Surgical Procedures, Embryoscopic,Surgical Procedures, Fetoscopic,Amnioscopic Surgery,Embryoscopic Surgery,Fetoscopic Surgery,Surgery, Amnioscopic,Surgery, Embryoscopic,Surgery, Fetoscopic,Amnioscopic Surgeries,Amnioscopic Surgical Procedure,Amnioscopies,Embryoscopic Surgeries,Embryoscopic Surgical Procedure,Embryoscopies,Fetoscopic Surgeries,Fetoscopic Surgical Procedure,Fetoscopies,Procedure, Amnioscopic Surgical,Procedure, Embryoscopic Surgical,Procedure, Fetoscopic Surgical,Procedures, Amnioscopic Surgical,Procedures, Embryoscopic Surgical,Procedures, Fetoscopic Surgical,Surgeries, Amnioscopic,Surgeries, Embryoscopic,Surgeries, Fetoscopic,Surgical Procedure, Amnioscopic,Surgical Procedure, Embryoscopic,Surgical Procedure, Fetoscopic
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
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective