Survival rate changes in children with congenital diaphragmatic hernia over the past three decades: a nationwide, population-based prospective nested case–control study
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In brief
In brief
This Swedish population-based study tracked survival outcomes for 684 children with congenital diaphragmatic hernia over three decades (1982-2015), demonstrating significant improvements in 2-year survival rates for both premature and term infants. Despite progress, CDH patients still face 5.8 times higher mortality risk compared to controls.
- CDH 2-year survival improved significantly over 3 decades (1982-2015), though mortality remains 5.8× higher than controls.
- 70.4% of CDH patients survived to age 2, compared to 99.6% of controls in this Swedish population-based study.
- CDH patients had 4× higher prematurity rate (23.3% vs 6.1%), but survival improved for both premature and term infants.
- Survival gains occurred across all gestational ages, suggesting advances in neonatal intensive care and surgical management.
Written by the GCMD Library team from the article.
Abstract
Purpose
The survival rate (SR) for neonates born with congenital diaphragmatic hernia (CDH) remains high. Our aim was to investigate the change in SR in children with CDH over the past decades.
Methods
The study was a nationwide, population-based prospective nested case–control study within a cohort of newborn children who was born in Sweden during the observational period from 1st January 1982 to 31st December 2015.
Results
In the study period, 4654 (99.6%) control children and 684 children with CDH (70.4%, p < 0.001) were with a survival of 2 years of age. Any patients who were born with CDH had a overall 5.8 times higher chance for not surviving 2 years of age than children without CDH. The SR improved significantly in CDH in the past 3 decades. Significantly higher number of patients were prematurely born in the CDH group than in the controls (23.3 vs 6.1%, p < 0.001). The SR of premature and non-premature born CDH patients has increased significantly over the past 3 decades.
Conclusion
The SR of CDH patients were significantly increased in the past 3 decades. The 2-year survival remains 5.8 times higher than those who were not born with CDH. These changes were mainly attributed to the improved SR of premature and non-premature born CDH patients.