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Article Dans Une Revue Prenatal Diagnosis Année : 2020

Is laterality of congenital diaphragmatic hernia a reliable prognostic factor? French national cohort study

1 SU - Sorbonne Université
2 CHU Trousseau [APHP]
3 Service de Gynécologie et Obstétrique [Marseille]
4 Service de chirurgie pédiatrique [CHU Strasbourg]
5 Unit of Neonatal Intensive Care [Strasbourg]
6 INCI - Institut des Neurosciences Cellulaires et Intégratives
7 Service d'Obstétrique et Gynécologique [AP-HP Hôpital Bicêtre]
8 Service de Gynécologie Obstétrique [CHU Necker]
9 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
10 Département d'obstétrique et de gynécologie [Hôpital Robert Debré]
11 HFME - Hôpital Femme Mère Enfant [CHU - HCL]
12 Département d'obstétrique[Lille]
13 Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes]
14 Département de Pédiatrie
15 Service Gynécologie [CHU Toulouse]
16 Department of Gynecology and Obstetrics, CHU Montpellier, Montpellier, France
17 Service de gynécologie, obstétrique, médecine et biologie de la reproduction [CHU Poitiers] = Department of Gynecology, Obstetrics, Reproductive Medicine and Biology [Poitiers University Hospital]
18 Service de Gynécologie-Obstétrique [CHRU Tours]
19 Service de Gynécologie et Obstétrique [CHU Rouen]
20 Service de Gynécologie-Obstétrique et Médecine de la Reproduction [CHU Caen]
21 Département d'obstétrique Gynécologie [, Amiens University Hospital, Amiens]
22 Service de Chirurgie pédiatrique [CHU Saint-Etienne]
23 Service d'obstétrique-gynécologie [Nantes]
24 PhAN - Physiopathologie des Adaptations Nutritionnelles
25 Service de chirurgie infantile, CHU Felix Guyon, Saint Denis de La Réunion
26 NICE - Réa Néonat - Service de Réanimation Néonatale
27 Pôle Entrepreneuriat et Innovation - Rouen Business School
28 Service de Gynécologie [CHU Clermont-Ferrand]
29 Service de Gynécologie-Obstétrique [CHU Limoges]
30 Le2i - Laboratoire Electronique, Informatique et Image [UMR6306]
31 Service d'Obstétrique et de Gynécologie [CHRU Nancy]
32 BREST - Gynéco-Obs - Service de Gynécologie-Obstétrique
33 Service de gynécologie-obstétrique [Angers]
34 Service de Gynécologie-Obstétrique, CHU Bordeaux, 33076 Bordeaux, France
35 Service de Gynécologie Obstétrique [CHRU Besançon]
36 Département d'échographie et de Médecine fœtale
37 Département de Gynécologie-Obstétrique [CHU Strasbourg]
38 Service de gynécologie-obstétrique, médecine de la reproduction [Béclère]
39 BB - Biomatériaux et Bioingénierie
Jean‐marie Jouannic

Résumé

Objectives: The objective of this study was to assess whether the laterality of congenital diaphragmatic hernia (CDH) was a prognostic factor for neonatal survival. Methods : This was a cohort study using the French national database of the Reference Center for Diaphragmatic Hernias. The principal endpoint was survival after hospitalization in intensive care. We made a comparative study between right CDH and left CDH by univariate and multivariate analysis. Terminations and stillbirths were excluded from analyses of neonatal outcomes. Results: A total of 506 CDH were included with 67 (13%) right CDH and 439 left CDH (87%). Rate of survival was 49% for right CDH and 74% for left CDH (P < .01). Multivariate analysis showed two factors significantly associated with mortality: thoracic herniation of liver (OR 2.27; IC 95% [1.07-4.76]; P = .03) and lung-to-head-ratio over under expected (OR 2.99; IC 95% [1.41-6.36]; P < .01). Side of CDH was not significantly associated with mortality (OR 1.87; IC 95% [0.61-5.51], P = .26). Conclusion : Rate of right CDH mortality is more important than left CDH. Nevertheless after adjusting for lung-to-head-ratio and thoracic herniation of liver, right CDH does not have a higher risk of mortality than left CDH.
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Dates et versions

hal-02615464 , version 1 (22-05-2020)

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Anne Pinton, Julia Boubnova, François Becmeur, Pierre Kuhn, Marie‐victoire Senat, et al.. Is laterality of congenital diaphragmatic hernia a reliable prognostic factor? French national cohort study. Prenatal Diagnosis, 2020, 40 (8), pp.949-957. ⟨10.1002/pd.5706⟩. ⟨hal-02615464⟩
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