title: Epidemiology and outcome of congenital diaphragmatic hernia: a 9-year experience.
abstract: The aim of this study was to report the birth prevalence and short-term outcome of congenital diaphragmatic hernia (CDH) in a large geographically defined population, and to assess the feasibility of performing a randomised control trial (RCT) in this population. Data were collected on all cases of CDH reported to the East Midlands and South Yorkshire Congenital Anomalies Register between 1997 and 2005. A total of 194 cases of CDH were identified from 547,025 births; a birth prevalence of 3.5/10,000. Overall 1-year survival was 42%. In total, 69% of cases resulted in a live birth, of these 61% survived to 1 year; 73% were diagnosed antenatally and 22% postnatally, with 1-year survivals 30% and 71%, respectively. A total of 54% were isolated cases and 46% associated with another anomaly, with more live births (80% vs. 56%) and better 1-year survival (62% vs. 19%) with isolated CDH. Overall, only 83 babies were born alive with an isolated CDH: the only group suitable for inclusion in a RCT. In conclusion, given the small numbers of live isolated CDH cases it is impossible that any network alone would be able to perform a valid RCT of treatments, highlighting the need for collaborative international trials to address this complex condition.
authors.affiliation: Department of Neonatology, University Hospitals of Leicester, Leicester, UK. joannawright@doctors.net.uk
authors.forename: Joanna C E
authors.initials: JC
authors.lastname: Wright
authors.forename: Judith L S
authors.initials: JL
authors.lastname: Budd
authors.forename: David J
authors.initials: DJ
authors.lastname: Field
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Draper
mesh_terms: D004739:England / Q000453:epidemiology; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D006548:Hernia, Diaphragmatic / Q000453:epidemiology; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011296:Prenatal Diagnosis; D016032:Randomized Controlled Trials as Topic