Prematurity and fetal lung response after tracheal occlusion in fetuses with severe congenital diaphragmatic hernia

Author(s):Show less -

Sananes, Nicolas ^{[1, 2]} ; Rodo, Carlota ^[3] ; Luis Peiro, Jose ^[3] ; Britto, Ingrid Schwach Werneck ^[2] ; Sangi-Haghpeykar, Haleh ^[2] ; Favre, Romain ^[1] ; Joal, Arnaud ^[1] ; Gaudineau, Adrien ^[1] ; da Silva, Marcos Marques ^[4] ; Tannuri, Uenis ^[4] ; Zugaib, Marcelo ^[5] ; Carreras, Elena ^[1] ; Ruano, Rodrigo ^{[5, 2]}

Affiliation

^[1] HUS, CMCO, Serv Gynecol Obstet, Strasbourg - France

^[2] Baylor Coll Med, Dept Obstet & Gynecol, Texas Childrens Fetal Ctr, Houston, TX 77030 - USA

^[3] Hosp Univ Vall Dhebron, Fetal Surg Program, Barcelona - Spain

^[4] Univ Sao Paulo, Fac Med, Dept Pediat Surg, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Fac Med, Dept Obstet & Gynecol, Sao Paulo - Brazil

• Document type: Journal article
• Source: Journal of Maternal-Fetal & Neonatal Medicine; v. 29, n. 18, p. 3030-3034, 2016.
• Web of Science Citations: 4

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 (537 weeks at delivery) and extreme prematurity (532 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. (AU)

• FAPESP's process: 13/12493-1 - Evaluation of pulmonary vascularization in fetuses with Congenital Diaphragmatic Hernia undergoing conservative treatment or fetal intervention through fetoscopic tracheal balloon placement
• Grantee: Ingrid Schwach Werneck Britto
• Support Opportunities: Scholarships abroad - Research