Epidemiology and outcome of congenital diaphragmatic hernia in a tertiary care university hospital: 10 Years' Experience

Abstract

Congenital diaphragmatic hernia (CDH) is a major birth defect, which continues to be associated with significant rate of morbidity and mortality. CDH-local studies are limited. The objective of this article is to determine the epidemiology and demographics of CDH; and if the introduction of nitric oxide has influenced the outcome. <b>Materials and Methods:</b> A retrospective 10-year medical records review of neonates with CDH admitted to the neonatal intensive care unit (NICU) of a tertiary care hospital. <b>Results:</b> A total of 29 infants had been admitted to the NICU with CDH between January 2001 and December 2010. The mean gestational age was 38.58 ΁ 2.6 weeks and the mean birth weight was 2821 ΁ 682 g. The incidence of CDH among the inborn infants was 1/250 live births (P &lt; 0.05) and the overall male to female ratio was 0.7. Of the 12 infants (41%) were inborn and 17 (59%) were referred from other centers. Out of the 29 infants, 23 (79%) were Saudis; the same figure was true for the vaginal deliveries and those born at term. Only 10 infants (34%) were diagnosed antenatally. The mean Apgar scores were 5 and 7 at the 1 ^st and 5 ^th min respectively. Two infants (7%) had right-sided defect against 27 (93%) who had it left-sided. Moreover, 18 infants had survived and were discharged home, with an overall mortality rate of 38% (compared with 45% before introducing inhaled nitric oxide [iNO]), P &gt; 0.05. <b>Conclusion:</b> The incidence of CDH was found much higher than the reported cases in literature; and although the mortality rate has improved after the introduction of iNO, the difference was not statistically significant. Both interesting findings necessitate further studies.