Predictors of Mortality and Morbidity in Infants with CDH

Aly, Hany; Abdel‐Hady, Hesham

doi:10.5772/35394

Cited by 2 publications

(2 citation statements)

References 125 publications

(158 reference statements)

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“…Poor lung function at birth typically requires complex and expensive medical and surgical interventions. With the improvements in prenatal diagnosis and newborn care, survival has increased, but still up to 30–40% of infants with CDH may not survive, and survivors often face long‐term complications (Abdullah et al, 2009; Aly & Hesham, 2012). Based on the prevalence estimate of 1 in 3,000 births, about 1,300 babies are born with CDH each year in the United States (Mesas Burgos, Ehren, Conner, & Frenckner, 2019; Shanmugam, Brunelli, Botto, Krikov, & Feldkamp, 2017).…”

Section: Introductionmentioning

confidence: 99%

Congenital diaphragmatic hernia and maternal dietary nutrient pathways and diet quality

Carmichael

Witte

et al. 2020

Birth Defects Research

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Introduction: We examined the association of congenital diaphragmatic hernia (CDH) with maternal dietary intake, using semi-Bayes hierarchical models and principal components analysis to consider intake of nutrients that contribute to one-carbon metabolism and oxidative stress pathways, and a diet quality index. Methods: We included data on 825 cases and 11,108 nonmalformed controls born from 1997-2011 whose mother participated in the National Birth Defects Prevention Study (NBDPS), a multisite, population-based case-control study. Exposure data were from maternal telephone interviews, which included a food frequency questionnaire. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were generated from logistic regression models that included nutritional factors as continuous variables and were adjusted for maternal energy intake, race-ethnicity, parity, and vitamin supplement intake. Results: In the semi-Bayes hierarchical model that included all nutrients and confounders, riboflavin was the only nutrient for which the 95% CI excluded 1.0; the aOR for a 1 SD increase was 0.83. The aORs were 0.79 (95% CI 0.69-0.91) for the one-carbon metabolism pathway score, 0.90 (95% CI 0.80-1.01) for oxidative stress, and 0.85 (95% CI 0.77-0.93) for diet quality (the aORs correspond to a 1 SD increase). Conclusions: The findings from this study provide some support for the hypothesis that better prepregnancy nutrition is associated with reduced risk for CDH. These results provide etiologic clues but should be interpreted with caution given the novelty of the investigation.

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Section: Introductionmentioning

confidence: 99%

Congenital diaphragmatic hernia and maternal dietary nutrient pathways and diet quality

Carmichael

Witte

et al. 2020

Birth Defects Research

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“…For sBPD, as the lung progresses into the late phase of the disease, there is varying airway resistance, lung compliance, and time constants. It is believed that optimal ventilation of late-phase sBPD lungs is a slow respiratory rate, a large VT, and a long Ti (10,11). Although widely accepted, there is limited evidence to support this latephase approach, partly because most methods for analyzing lung function are difficult to carry out in infants and limited to whole lung measurements rather than evaluation of the individual regions of the heterogeneous sBPD lung.…”

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confidence: 99%

Magentic Resonance Imaging Evaluation of Regional Lung Vts in Severe Neonatal Bronchopulmonary Dysplasia

Gouwens

Higano

Marks

et al. 2020

Am J Respir Crit Care Med

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Rationale: Bronchopulmonary dysplasia is a heterogeneous lung disease characterized by regions of cysts and fibrosis, but methods for evaluating lung function are limited to whole lung rather than specific regions of interest.Objectives: Respiratory-gated, ultrashort echo time magnetic resonance imaging was used to test the hypothesis that cystic regions of the lung will exhibit a quantifiable VT that will correlate with ventilator settings and clinical outcomes.Methods: Magnetic resonance images of 17 nonsedated, quietbreathing infants with severe bronchopulmonary dysplasia were reconstructed into end-inspiration and end-expiration images. Cysts were identified and measured by using density threshold combined with manual identification and segmentation. Regional VTs were calculated by subtracting end-expiration from end-inspiration volumes in total lung, noncystic lung, total-cystic lung, and individual large cysts.Measurements and Main Results: Cystic lung areas averaged larger VTs than noncystic lung when normalized by volume (0.8 ml VT/ml lung vs. 0.1 ml VT/ml lung, P , 0.002). Cyst VT correlates with cyst size (P = 0.012 for total lung cyst and P , 0.002 for large cysts), although there was variability between individual cyst VT, with 22% of cysts demonstrating negative VT. Peak inspiratory pressure positively correlated with total lung VT (P = 0.027) and noncystic VT (P = 0.015) but not total lung cyst VT (P = 0.8). Inspiratory time and respiratory rate did not improve VT of any analyzed lung region.Conclusions: Cystic lung has greater normalized VT when compared with noncystic lung. Ventilator pressure increases noncystic lung VT, but inspiratory time does not correlate with VT of normal or cystic lung.

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Predictors of Mortality and Morbidity in Infants with CDH

Cited by 2 publications

References 125 publications

Congenital diaphragmatic hernia and maternal dietary nutrient pathways and diet quality

Congenital diaphragmatic hernia and maternal dietary nutrient pathways and diet quality

Magentic Resonance Imaging Evaluation of Regional Lung Vts in Severe Neonatal Bronchopulmonary Dysplasia

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