Abstract
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a malformation of the diaphragm accounting for 8% of all major congenital anomalies. While many clinical factors of survival in children with CDH have been established, limited research exists on the role of sociodemographic and other factors. We aimed to systematically identify and summarise all available international literature, published from January 2000 to July 2017, evaluating specific mortality factors for children with prenatally-diagnosed, isolated, left-sided CDH.
METHODS: MEDLINE, PROSPERO, EMBASE, Scopus, The Cochrane Library databases and the table of contents for the past five years for relevant journals were searched systematically. The risk factors of interest were: birth weight, gestational age (GA) at diagnosis, GA at birth, infant sex, maternal age, ethnicity, socioeconomic status (SES) and plurality. The primary outcome measure was survival. Data were extracted on study design, study quality, participant data and survival-related effect estimates.
RESULTS: Seven studies fulfilled the inclusion criteria. In total, 347 children were included in the review. Birth weight, GA at diagnosis and GA at birth were evaluated in five studies each, infant sex in two and maternal age in one. None of these factors were significantly associated with survival. No studies evaluated the influence of plurality, ethnicity or SES.
CONCLUSION: Whilst the factors of interest showed no significant association with survival, more evidence is required to confirm these findings. Understanding whether sociodemographic factors are associated with survival may help inform the development of public health interventions to improve survival rates for children with CDH.
METHODS: MEDLINE, PROSPERO, EMBASE, Scopus, The Cochrane Library databases and the table of contents for the past five years for relevant journals were searched systematically. The risk factors of interest were: birth weight, gestational age (GA) at diagnosis, GA at birth, infant sex, maternal age, ethnicity, socioeconomic status (SES) and plurality. The primary outcome measure was survival. Data were extracted on study design, study quality, participant data and survival-related effect estimates.
RESULTS: Seven studies fulfilled the inclusion criteria. In total, 347 children were included in the review. Birth weight, GA at diagnosis and GA at birth were evaluated in five studies each, infant sex in two and maternal age in one. None of these factors were significantly associated with survival. No studies evaluated the influence of plurality, ethnicity or SES.
CONCLUSION: Whilst the factors of interest showed no significant association with survival, more evidence is required to confirm these findings. Understanding whether sociodemographic factors are associated with survival may help inform the development of public health interventions to improve survival rates for children with CDH.
| Original language | English |
|---|---|
| Pages (from-to) | 1241-1249 |
| Number of pages | 9 |
| Journal | Birth Defects Research |
| Volume | 110 |
| Issue number | 16 |
| Early online date | 10 Sept 2018 |
| DOIs | |
| Publication status | Published - 2 Oct 2018 |
Bibliographical note
Acknowledgements: We thank Alex Inskip, senior library assistant at Newcastle University, for assistance in utilising the databases and composing the search strategy.Funding Source: RV is funded by Public Health England (PHE).
Keywords
- congenital diaphragmatic hernia
- mortality factors
- sociodemographic
- public health
Access to Document
- Accepted Manuscript
This is the peer reviewed version of the following article:Vieira R, Pearse R, Rankin J. Mortality factors in infants with congenital diaphragmatic hernia: A systematic review. Birth Defects Research. 2018;110:1241–1249., which has been published in final form at https://doi.org/10.1002/bdr2.1376. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.