Study of Mortality and Morbidity in Neonates with Congenital Diaphragmatic Hernia

Introduction: Congenital diaphragmatic hernia may either lead to death or cause several complications such as increased pulmonary artery pressure.

Objective: The present study aimed to compare mortality and morbidity, vasopressor intake, and visceral hernia of CDH neonates with pulmonary hypertension and without pulmonary hypertension in Mahdieh and Mofid hospitals in Tehran.

Methods: This cross-sectional analytical study included 56 neonates with congenital diaphragmatic hernia who were admitted to Mofid and Mahdieh Children's Hospitals from 2014 to 2018. The sample size included 56 people selected based on census method. We compared the pulmonary hypertension and non-pulmonary hypertension groups in variables, such as gender, gestational age, birth weight, place of birth, and type of delivery and we examined relationship between pulmonary hypertension and mortality and morbidity and relationship between mortality and vasopressor intake.

Results: The OR value was calculated to be 1.106, which is significant at the level of 0.004 (p < 0.01). This finding indicated that the chance of death in the group of infants with severe pulmonary hypertension was increased by 1.106. Also, the relationship of visceral hernia (stomach, intestine, liver, kidney, and spleen) to thorax was examined by logistic regression. Only the OR value of liver hernia (9.42) was significant (p < 0.001), indicating that the chance of death was higher in infants with liver hernias. It also the OR value of dopamine, dobutamine, and milrinone was significant (p < 0.01).

Conclusion: In general, the results obtained in our study indicated that the mortality rate in the group of infants with pulmonary hypertension was significantly higher than the group without pulmonary hypertension. Also, liver hernia to thorax was associated with the severity of pulmonary hypertension, and the patients needed medication had a higher chance of death.