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Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis

Journal of Perinatology volume 43, pages 884–888 (2023)Cite this article

Subjects

Abstract

Objectives

To evaluate the survival and intact-survival rates among preterm infants with congenital diaphragm hernia (CDH).

Study design

Multicenter retrospective cohort study of 849 infants born between 2006 and 2020 at 15 Japanese CDH study group facilities. Multivariate logistic regression analysis adjusted using inverse probability treatment weighting (IPTW) method was used. We also compare trends of intact-survival rates among term and preterm infants with CDH.

Results

After adjusting using the IPTW method for CDH severity, sex, APGAR score at 5 min, and cesarean delivery, gestational age and survival rates have a significantly positive correlation [coefficient of determination (COEF) 3.40, 95% confidence interval (CI), 1.58–5.21, p value <0.001] and higher intact-survival rate [COEF 2.39, 95% CI, 1.73–4.06, p value 0.005]. Trends of intact-survival rates for both preterm and term infants had significantly changed, but improvement in preterm infants was much smaller than in term infants.

Conclusion

Prematurity was a significant risk factor for survival and intact-survival among infants with CDH, regardless of adjustment for CDH severity.

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Data availability

The research data obtained from the included articles are available and can be requested from corresponding author and will be made available when requested.

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Funding

This work was supported by a grant from the Ministry of Health, Labor and Welfare of Japan (Grant No. 20FC1017).

Author information

Authors and Affiliations

  1. Department of Neonatal Medicine, Osaka Women’s and Children’s Hospital, Izumi, Japan

    Yousuke Imanishi

  2. Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital, Izumi, Japan

    Noriaki Usui

  3. Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Taizo Furukawa

  4. Department of Pediatric Surgery, Reproductive and Developmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kouji Nagata

  5. Division of Neonatology, Center for Maternal‑Neonatal Care, Nagoya University Hospital, Nagoya, Japan

    Masahiro Hayakawa

  6. Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan

    Shoichiro Amari

  7. Department of Pediatric Surgery, Kobe Children’s Hospital, Kobe, Japan

    Akiko Yokoi

  8. Department of Pediatric Surgery, Tsukuba University, Tsukuba, Japan

    Kouji Masumoto

  9. Department of Pediatric Surgery, Shizuoka Children’s Hospital, Shizuoka, Japan

    Masaya Yamoto

  10. Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Urayasu, Japan

    Tadaharu Okazaki

  11. Department of Pediatrics, Kinki University, Higashiosaka, Japan

    Noboru Inamura

  12. Department of Neonatology, Kanagawa Children’s Medical Center, Yokohama, Kanagawa, Japan

    Katsuaki Toyoshima

  13. Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan

    Keita Terui

  14. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Hiroomi Okuyama

Authors
  1. Yousuke Imanishi
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Contributions

YI and NU were involved in study design and data interpretation. YI and NU were involved in the data analysis. All authors critically revised the report, commented on the paper drafts, and approved the final paper.

Corresponding author

Correspondence to Yousuke Imanishi.

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Competing interests

The authors declare no competing interests.

Ethics approval

The study protocol was reviewed and approved by the institutional ethics committee of Osaka Women’s and Children’s Hospital (No.11017) and the institutional review board of all participating institutions.

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Imanishi, Y., Usui, N., Furukawa, T. et al. Outcomes of congenital diaphragmatic hernia among preterm infants: inverse probability of treatment weighting analysis. J Perinatol 43, 884–888 (2023). https://doi.org/10.1038/s41372-023-01647-y

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  • DOI: https://doi.org/10.1038/s41372-023-01647-y

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