title: Assessment of quality of life outcomes using the pediatric quality of life inventory survey in prenatally diagnosed congenital diaphragmatic hernia patients.
abstract: BACKGROUND
  Congenital diaphragmatic hernia patients can have significant postnatal morbidity. To date, there has been no quality of life (QOL) study in a prenatally diagnosed CDH patient population, assessing prenatal disease severity and QOL. The purpose of this pilot study was to assess the QOL in a single institution fetal center CDH experience.
  
  
  METHODS
  The study was a retrospective cohort study of CDH patients diagnosed by fetal ultrasound and MRI at a fetal center between March 2002-March 2014. Parents of children ≥2years were contacted by telephone to participate in the validated Pediatric Quality of Life Inventory (PedsQL™, Version 4.0).
  
  
  RESULTS
  Of 95 CDH survivors, 68 met inclusion criteria, of which 28 (42%) completed the survey (mean age, range: 5.5, 2.3-11.7years). Based on prenatal markers of disease severity, there were no differences in performance between those with mild or severe forms of CDH. Overall, patients had minimal QOL limitations, but those with limitations had a higher risk for oxygen dependence at 30days of life (71%v. 29%, OR 0.16, CI, 0.031-0.82, p=0.02). ECMO was not associated with significantly worse QOL in physical or psychosocial functioning. Cronbach's alpha reliability coefficient yielded a correlation of 0.951 for the overall survey, 0.911 for physical functioning, and 0.901 for psychosocial functioning questions.
  
  
  CONCLUSIONS
  Patients that are prenatally diagnosed with severe forms of CDH have similar QOL outcomes across all categories of physical and psychosocial functioning. This pilot study is encouraging and may allow improved counseling for expectant parents of CDH patients.
authors.affiliation: Texas Children's Fetal Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Fariha
authors.initials: F
authors.lastname: Sheikh
authors.affiliation: Texas Children's Fetal Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Adesola
authors.initials: A
authors.lastname: Akinkuotu
authors.affiliation: Texas Children's Fetal Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Sarah Jane
authors.initials: SJ
authors.lastname: Clark
authors.affiliation: Texas Children's Fetal Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Irving J
authors.initials: IJ
authors.lastname: Zamora
authors.affiliation: Texas Children's Fetal Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Darrell L
authors.initials: DL
authors.lastname: Cass
authors.affiliation: Texas Children's Fetal Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX.
authors.forename: Oluyinka
authors.initials: O
authors.lastname: Olutoye
authors.affiliation: Texas Children's Fetal Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX. Electronic address: timlee@bcm.edu.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Lee
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006305:Health Status Indicators; D065630:Hernias, Diaphragmatic, Congenital / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011788:Quality of Life; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Congenital diaphragmatic hernia; Prenatal; Quality of life