Link: http://www.ncbi.nlm.nih.gov/pubmed/26633729

AbstractSend to:
J Matern Fetal Neonatal Med. 2015 Dec 2:1-5. [Epub ahead of print]
Prematurity and fetal lung response after tracheal occlusion in fetuses with severe congenital diaphragmatic hernia.
Sananes N1,2, Rodo C3, Peiro JL3, Britto IS1, Sangi-Haghpeykar H1, Favre R2, Joal A2, Gaudineau A2, Silva MM4, Tannuri U4, Zugaib M5, Carreras E2, Ruano R1,5.
Author information
Abstract
OBJECTIVE:
To evaluate the independent association of fetal pulmonary response and prematurity to postnatal outcomes after fetal tracheal occlusion for congenital diaphragmatic hernia.

METHODS:
Fetal pulmonary response, prematurity (<37 weeks at delivery) and extreme prematurity (<32 weeks at delivery) were evaluated and compared between survivors and non-survivors at 6 months of life. Multivariable analysis was conducted with generalized linear mixed models for variables significantly associated with survival in univariate analysis.

RESULTS:
Eighty-four infants were included, of whom 40 survived (47.6%) and 44 died (52.4%). Univariate analysis demonstrated that survival was associated with greater lung response (p=0.006), and the absence of extreme preterm delivery (p=0.044). In multivariable analysis, greater pulmonary response after FETO was an independent predictor of survival (aOR 1.87, 95% CI 1.08-3.33, p=0.023), whereas the presence of extreme prematurity was not statistically associated with mortality after controlling for fetal pulmonary response (aOR 0.52, 95% CI 0.12-2.30, p=0.367).

CONCLUSION:
Fetal pulmonary response after FETO is the most important factor associated with survival, independently from the gestational age at delivery.

KEYWORDS:
Congenital diaphragmatic hernia; fetal lung; fetal surgery; fetoscopy; lung-to-head ratio; prematurity