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Incidence, Predictors and Outcomes of Congenital Diaphragmatic Hernia: A Population-Based Study of 32 Million Births in the United States.
MedLine Citation:
PMID:  24156638     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objectives: To evaluate the incidence, risk factors and neonatal outcomes associated with a congenital diaphragmatic hernia (CDH). Study Design: We conducted a population-based cohort study using the CDC's Linked Birth-Infant Death and Fetal Death data files on all births and fetal deaths in the United States between 1995 and 2002. We estimated the yearly incidence of CDH and measured its adjusted effect on various outcomes using unconditional logistic regression analysis. Results: 32,145,448 births during the 8-year study period met the study's inclusion criteria. The incidence of CDH was 1.93/10,000 births. Risk factors for the development of CDH included fetal male gender [OR 1.12, 95% CI: 1.06, 1.17], maternal age beyond 40 [OR 1.51, 95% CI: 1.26, 1.80], Caucasian ethnicity [OR 1.15, 95% CI: 1.10, 1.21], smoking [OR 1.34, 95% CI: 1.22, 1.46] and alcohol use during pregnancy [OR 1.37, 95% CI: 1.05, 1.79]. As compared to fetuses with no CDH, fetuses with CDH were at an increased risk of preterm birth [OR 2.90, 95% CI: 2.72, 3.11], IUGR [OR 3.84, 95% CI: 3.51, 4.18], stillbirth [OR 9.65, 95% CI: 8.20, 11.37], and overall infant death [OR: 94.80, 95% CI: 88.78, 101.23]. The 1-year mortality was 45.89%. Conclusion: Congenital diaphragmatic hernia is strongly associated with an increased risk of adverse pregnancy, fetal and neonatal outcomes. These findings may be helpful in counselling pregnancies affected by CDH, and may aid in the understanding of the burden of this condition at the public health level.
Authors:
Jacques Balayla; Haim A Abenhaim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-25
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Obstetrics and Gynecology, University of Montreal, Montreal, QC, Canada.
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