Prematurity and fetal lung response after tracheal occlusion in fetuses with severe congenital diaphragmatic hernia

Nicolas Sananes, Carlota Rodo, Jose Luis Peiro, Ingrid Schwach Werneck Britto, Haleh Sangi-Haghpeykar, Romain Favre, Arnaud Joal, Adrien Gaudineau, Marcos Marques da Silva, Uenis Tannuri, Marcelo Zugaib, Elena Carreras, Rodrigo Ruano

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: To evaluate the independent association of fetal pulmonary response and prematurity to postnatal outcomes after fetal tracheal occlusion for congenital diaphragmatic hernia. Methods: Fetal pulmonary response, prematurity (<37 weeks at delivery) and extreme prematurity (<32 weeks at delivery) were evaluated and compared between survivors and non-survivors at 6 months of life. Multivariable analysis was conducted with generalized linear mixed models for variables significantly associated with survival in univariate analysis. Results: Eighty-four infants were included, of whom 40 survived (47.6%) and 44 died (52.4%). Univariate analysis demonstrated that survival was associated with greater lung response (p=0.006), and the absence of extreme preterm delivery (p=0.044). In multivariable analysis, greater pulmonary response after FETO was an independent predictor of survival (aOR 1.87, 95% CI 1.08–3.33, p=0.023), whereas the presence of extreme prematurity was not statistically associated with mortality after controlling for fetal pulmonary response (aOR 0.52, 95% CI 0.12–2.30, p=0.367). Conclusion: Fetal pulmonary response after FETO is the most important factor associated with survival, independently from the gestational age at delivery.

Original languageEnglish (US)
Pages (from-to)3030-3034
Number of pages5
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume29
Issue number18
DOIs
StatePublished - Sep 16 2016
Externally publishedYes

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Keywords

  • Congenital diaphragmatic hernia
  • fetal lung
  • fetal surgery
  • fetoscopy
  • lung-to-head ratio
  • prematurity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Sananes, N., Rodo, C., Peiro, J. L., Britto, I. S. W., Sangi-Haghpeykar, H., Favre, R., Joal, A., Gaudineau, A., Silva, M. M. D., Tannuri, U., Zugaib, M., Carreras, E., & Ruano, R. (2016). Prematurity and fetal lung response after tracheal occlusion in fetuses with severe congenital diaphragmatic hernia. Journal of Maternal-Fetal and Neonatal Medicine, 29(18), 3030-3034. https://doi.org/10.3109/14767058.2015.1114080