title: Congenital Diaphragmatic Hernia: The Side of Diaphragmatic Defect and Associated Nondiaphragmatic Malformations.
abstract: BackgroundCongenital diaphragmatic hernia (CDH) has different clinical presentations depending on whether it is right sided (R-CDH) or left sided (L-CDH). Some have suggested that L-CDH and R-CDH may represent different syndromic phenotypes. This theory would be indirectly supported if different nondiaphragmatic anomalies were associated with laterality. We assessed whether CDH laterality is associated with specific types of nondiaphragmatic anomalies.MethodsCases of CDH were retrospectively identified from five centers, and associated congenital anomalies, prenatal diagnosis, demographics, birth characteristics, and side of the CDH were analyzed. CDH characteristics were summarized according to the absence (isolated) or presence (complex) of nondiaphragmatic malformations.ResultsAmong 228 neonates with CDH, 140 (61%) had isolated CDH and 88 (39%) had complex CDH. Complex CDH was significantly associated with being small for gestational age (odds ratio [95% confidence interval, CI]: 8.3 [1.9-35.7];p= 0.005) and having L-CDH (odds ratio [95% CI]: 3.6 [1.5-8.9];p= 0.005). The overall proportion with anomalies differed by side (42% for L-CDH, 23% for R-CDH;p= 0.02), but the rates of anomalies in specific organ systems did not differ.ConclusionThe rate of associated nondiaphragmatic anomalies by specific organ system did not differ between L-CDH and R-CDH, which suggests that they represent the same phenotypic entity.
authors.affiliation: Department of Pediatrics, University of Zagreb, University Hospital Centre Zagreb, School of Medicine, Zagreb, Croatia.
authors.forename: Ruža
authors.initials: R
authors.lastname: Grizelj
authors.affiliation: Division of Neonatology, Department of Obstetrics and Gynecology, University Hospital Merkur, Zagreb, Croatia.
authors.forename: Katarina
authors.initials: K
authors.lastname: Bojanić
authors.affiliation: Department of Pediatrics, University of Zagreb, University Hospital Centre Zagreb, School of Medicine, Zagreb, Croatia.
authors.forename: Jurica
authors.initials: J
authors.lastname: Vuković
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Toby N
authors.initials: TN
authors.lastname: Weingarten
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Darrell R
authors.initials: DR
authors.lastname: Schroeder
authors.affiliation: Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Juraj
authors.initials: J
authors.lastname: Sprung
mesh_terms: D000015:Abnormalities, Multiple / Q000473:pathology*; D017523:Croatia; D005260:Female; D065630:Hernias, Diaphragmatic, Congenital / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008910:Minnesota; D015999:Multivariate Analysis; D010641:Phenotype; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies