Neonatal outcomes of congenital diaphragmatic hernia in full term versus early term deliveries: A systematic review and meta-analysis |
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| Authors: | Kazuya Mimura Masayuki Endo Yoko Kawanishi Takeshi Kanagawa Kouji Nagata Keita Terui Makoto Fujii Masayuki Shiraishi Masaya Yamoto Miharu Ito Atsuo Itakura Hiroomi Okuyama Noriaki Usui the Japanese Congenital Diaphragmatic Hernia Study Group |
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| Institution: | 1. Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Suita, Japan;2. Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Suita, Japan;3. Department of Pediatric Surgery, Kyushu University, Fukuoka, Japan;4. Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan;5. Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Japan;6. Osaka University Library, Suita, Japan;7. Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan;8. Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan;9. Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan;10. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Japan;11. Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan |
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| Abstract: | This systematic review and meta-analysis aimed to review the optimal timing of delivery at term for neonates with prenatally diagnosed congenital diaphragmatic hernia (CDH). We reviewed the literature up to December 19, 2022 using MEDLINE and the Cochrane Library databases. The inclusion criteria were original articles, comparative studies of CDH neonates delivered at an early term (37–38 weeks of gestation) and at full term (39 weeks of gestation or later), and comparative studies investigating outcomes of CDH neonates. Six studies met the inclusion criteria, including 985 neonates delivered at an early term and 629 delivered at full term. The cumulative rate of survival to discharge showed no significant difference between CDH neonates delivered at an early term (395/515; 76.7%) or at full term (345/467; 73.9%) (risk ratio RR] 1.01; 95% confidence interval CI], 0.89–1.16; p = 0.85). Furthermore, the number of neonates requiring oxygen therapy at discharge was not significantly different between CDH neonates delivered at an early term (32/370; 8.6%) and at full term (14/154; 9.1%) (RR, 0.99; 95% CI, 0.36–2.70; p = 0.99). Therefore, the optimal timing of delivery at term for neonates with CDH remains unclear. |
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