Mortality factors in infants with congenital diaphragmatic hernia: A systematic review

Rute Vieira* (Corresponding Author), Rachel Pearse, Judith Rankin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
11 Downloads (Pure)


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.
Original languageEnglish
Pages (from-to)1241-1249
Number of pages9
JournalBirth Defects Research
Issue number16
Early online date10 Sept 2018
Publication statusPublished - 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).


  • congenital diaphragmatic hernia
  • mortality factors
  • sociodemographic
  • public health


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