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Optimal timing of delivery for pregnancies with prenatally diagnosed congenital diaphragmatic hernia: a propensity-score analysis using the inverse probability of treatment weighting

Abstract

Objective

To evaluate the optimal timing of neonates with prenatally diagnosed congenital diaphragmatic hernia (CDH).

Methods

Data from a retrospective cohort study conducted by the Japanese CDH Study Group between 2011 and 2018 were divided into two groups according to delivery timing: 36–37 and 38–41 weeks of gestation (wg). Death before 90 days as the primary outcome and the duration of hospitalization, oxygen therapy and tube feeding at discharge as the secondary outcomes were analyzed with generalized linear model applying inverse probability of treatment weighting method. We also performed layered analysis according to stomach position.

Result

Among 493 neonates with prenatally diagnosed, isolated and left CDH, 237 were born at 38–41wg. The duration of hospitalization was significantly shorter in those born at 38–41wg, especially among those with stomach malposition, and the other outcomes showed no difference.

Conclusions

Delivery at 38–41wg could be beneficial for those with high grade stomach position.

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Fig. 1: Distribution of cases.

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Acknowledgements

We thank all institutions that collected the data used for the present study.

Funding

The Health and Labor Sciences Research Grants for Research on Intractable Diseases from the Ministry of Health, Labor and Welfare of Japan.

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Authors and Affiliations

Authors

Contributions

YK mainly contributed to the design of the work, data analysis and interpretation of the work and drafting. EM contributed to the design of the work and interpretation of data for work. MF and TM supervised the analysis. NU, KN, KT, MH, SA, KM, TO, NI, NU, KT, KU, TF, MO, AY, and TT contributed to data collection, making revisions for the draft and interpretation of the work. HO contributed to data collection, supported the study design, revised the draft, and approved the final version to be published.

Corresponding author

Correspondence to Hiroomi Okuyama.

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The authors declare no competing interests.

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Kawanishi, Y., Endo, M., Fujii, M. et al. Optimal timing of delivery for pregnancies with prenatally diagnosed congenital diaphragmatic hernia: a propensity-score analysis using the inverse probability of treatment weighting. J Perinatol 41, 1893–1900 (2021). https://doi.org/10.1038/s41372-021-01118-2

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