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Assessment of pulmonary artery size at birth as a prognostic factor in congenital diaphragmatic hernia: results of a multicenter study in Japan

Journal of Perinatology volume 43, pages 1295–1300 (2023)Cite this article

Subjects

Abstract

Objective

To assess the reliability of pulmonary artery (PA) parameters as a prognostic marker in neonates with isolated left-sided congenital diaphragmatic hernia (IL-CDH).

Study design

A retrospective cohort study conducted by the Japanese CDH Study Group (JCDHSG).

Results

323 IL-CDH patients registered with the JCDHSG were included. 272 patients survived to 90 days of age. Right PA (RPA) and left PA (LPA) diameters and pulmonary artery index (PAIndex) at birth were significantly larger in survivors. The cutoff values of RPA and LPA diameters and PAIndex for survival up to 90 days were 3.2 mm, 2.8 mm and 83.7, respectively, and logistic regression analysis showed that these were significantly related to survival. Multiple logistic regression analysis showed that both the PA parameters and liver herniation were significantly related to survival.

Conclusions

The three PA parameters at birth can predict clinical outcomes and are considered as independent risk factors of liver herniation.

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Fig. 1: Receiver operating characteristic (ROC) curves of the parameters.
Fig. 2: Receiver operating characteristic (ROC) curves of the combination of the parameters.

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Data availability

The datasets generated and/analyzed during current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank all members of JCDHSG for managements of patients and registrations to the database of JCDHSG. Funding: This study was funded by the Ministry of Health, Labour, and Welfare of Japan (Grant/Award Number: H24-Ninchi-Ippan-034).

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Chiba, Japan

    Tadaharu Okazaki

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

    Keita Terui

  3. Department of Pediatric Surgery, Kyushu University, Fukuoka, Japan

    Kouji Nagata

  4. Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan

    Masahiro Hayakawa

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

    Hiroomi Okuyama

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

    Shoichiro Amari

  7. Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    Kouji Masumoto

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

    Masaya Yamoto

  9. Department of Pediatrics, Kindai University, Faculty of Medicine, Osaka-Sayama, Japan

    Noboru Inamura

  10. Departments of Neonatology, Kanagawa Children’s Medical Center, Yokohama, Japan

    Katsuaki Toyoshima

  11. Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Taizo Furukawa

  12. Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan

    Manabu Okawada

  13. Department of Pediatric Surgery, Hyogo Children’s Hospital, Hyogo, Japan

    Akiko Yokoi

  14. Department of Pediatric Surgery, Mie University, Mie, Japan

    Yuki Koike

  15. Medical Technology Innovation Center, Clinical Research and Trial Center, Juntendo University, Tokyo, Japan

    Shuko Nojiri & Naotake Yanagisawa

  16. Division of Medial education, Juntendo University School of Medicine, Tokyo, Japan

    Yuji Nishizaki

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

    Noriaki Usui

Authors
  1. Tadaharu Okazaki
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  2. Keita Terui
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  18. Noriaki Usui
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Contributions

TO, KT, OH, SA, and NI made substantial contributions to the study conception and design. All authors performed clinical data collection. SN, YN, and NY made substantial contributions to statistical analysis and data interpretation. TO drafted the manuscript, and KT, MH, OH, KN, and NU reviewed the manuscript and provided critical feedback. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Tadaharu Okazaki.

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Competing interests

The authors declare no competing interests.

Ethical approval

The protocol of this study was approved by the Ethics Committee of Osaka University Hospital (approval number 11017) and the committees at all participating institutions. The investigation was performed in accordance with the principles of the Declaration of Helsinki and the Ethical Guidelines for Medical and Health Research Involving Human Subjects.

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Okazaki, T., Terui, K., Nagata, K. et al. Assessment of pulmonary artery size at birth as a prognostic factor in congenital diaphragmatic hernia: results of a multicenter study in Japan. J Perinatol 43, 1295–1300 (2023). https://doi.org/10.1038/s41372-023-01750-0

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