[Prognostic factors associated with mortality in newborns with congenital diaphragmatic hernia].
The objective was to identify prognostic factors associated with mortality in newborns with congenital diaphragmatic hernia.


METHODS
Study design was cases and controls nested in a cohort. We studied 65 newborns. Variables analyzed included gestational age, birth weight, Apgar and Silverman scores, surgery timing, presence of pneumothorax, degree of pulmonary hypoplasia, persistent pulmonary hypertension, mean airway pressure, blood gas analysis, ventilatory indexes, and risk of death score at admission.


RESULTS
Median gestational age was 38 weeks and median birth weight was 2,975 g. Lung hypoplasia ranged from 20-95%. Mortality was 40%; its main cause was persistent pulmonary hypertension. In multivariate analysis significant prognostic factors were risk of death > 50% (ORa = 59, 95% Confidence interval [CI] = 9.6-361) and mean airway pressure > 13 (ORa = 6, 95% CI = 1.2-29).


CONCLUSIONS
Factors that influence prognosis of newborns with congenital diaphragmatic hernia are related with ventilation process as well as mortality risk score at admission to neonatal intensive care unit.
J-García
Heladia
H
Unidad de Cuidados Intensivos Neonatales, Hospital de Pediatría, CMN Siglo XXI, IMSS, Av. Cuauhtémoc 330, Col. Doctores, México, D.F. CP. 06725. hely1802@yahoo.com.mx
Aparicio-de la Luz
Silvia
S
Franco-Gutiérrez
Mario
M
González-Lara
David
D
González-Cabello
Héctor
H
Villegas-Silva
Raúl
R
D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006548:Hernia, Diaphragmatic / Q000175:diagnosis / Q000401:mortality*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008168:Lung / Q000473:pathology / Q000503:physiopathology; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000175:diagnosis; D011379:Prognosis; D012123:Pulmonary Ventilation; D012307:Risk Factors