Observed-to-expected MRI fetal lung volume can predict long-term lung morbidity in infants with congenital diaphragmatic hernia

J Matern Fetal Neonatal Med. 2017 Jul;30(13):1509-1513. doi: 10.1080/14767058.2017.1299126. Epub 2017 Mar 9.

Abstract

Objective: Congenital diaphragmatic hernia (CDH) causes pulmonary hypoplasia and pulmonary hypertension, which are associated with long-term respiratory problems in infants. The aim of this study was to establish a marker for predicting lung function at 1 year of age in infants with CDH.

Materials and methods: Infants with isolated CDH who were delivered after 35 weeks of gestation from April 2008 to June 2016 at Nagoya University Hospital were registered. Regarding alive infants with CDH, only those who underwent follow-up for at least 1 year were registered. Finally, 48 infants were analyzed in this study.

Results: Gestational age at diagnosis, amniotic lamellar body count at birth, observed-to-expected MRI fetal lung volume (percent FLV), liver herniation, and polyhydramnios were found to be significant parameters for predicting mortality in infants with CDH. Regarding alive infants with CDH, percent FLV was the only significant parameter to predict need for oxygen therapy at 1 year of age (p < .05). There was a significant negative correlation between percent FLV and duration of oxygen therapy in infants with CDH (r = .516, p < .001).

Conclusions: Percent FLV is a useful predictor of long-term lung morbidity in infants with CDH.

Keywords: Congenital diaphragmatic hernia; MRI; fetal lung volume; lung hypoplasia; morbidity.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Female
  • Fetal Development
  • Gestational Age
  • Hernias, Diaphragmatic, Congenital / complications*
  • Hernias, Diaphragmatic, Congenital / diagnostic imaging
  • Hernias, Diaphragmatic, Congenital / mortality
  • Humans
  • Infant
  • Infant, Newborn
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Lung Volume Measurements
  • Magnetic Resonance Imaging / methods*
  • Male
  • Organ Size
  • Oxygen Inhalation Therapy / statistics & numerical data
  • Polyhydramnios
  • Predictive Value of Tests
  • Pregnancy
  • Prenatal Diagnosis / methods*
  • Young Adult