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Am J Perinatol 2019; 36(12): 1304-1309
DOI: 10.1055/s-0038-1676830
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Outcomes of Congenital Diaphragmatic Hernia in One of the Twins

Weipeng Wang   *
1   Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Weihua Pan   *
1   Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Jie Chen
1   Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Wei Xie
2   Department of Pediatric Surgery Intensive Care Unit, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Ming Liu
3   Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
,
Jun Wang
1   Department of Pediatric Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
› Author Affiliations Funding This study was funded by Shanghai Jiao Tong University School of Medicine (grant numbers JQ201708). We would like to thank Shourong Huang for collecting the data.
Further Information

Publication History

15 August 2018

16 November 2018

Publication Date:
04 January 2019 (online)

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Abstract

Objective Congenital diaphragmatic hernia (CDH) occurred in one of the twins is rarely seen. This study aims to describe the clinical features and outcomes of this special CDH.

Study Design The medical records of all CDH neonates treated in our institution between 2010 and 2016 were retrospectively reviewed. Data were analyzed using parametric and nonparametric tests, appropriately. Association between the twin pregnancy and outcomes was assessed.

Results Eighty-nine patients met the inclusion criteria. In the multivariate analysis, liver herniation, observed/expected lung-to-head circumference ratio, and lower birth weight were independently related to the survival rate of CDH. Eleven patients were identified with CDH occurred in only one of the twins. Among them, seven patients (63.6%) were premature and six (54.5%) were found with low birth weight. Compared with CDH patients with singleton pregnancy, they had significantly higher rates of prematurity (p < 0.001) and lower birth weight (p < 0.001). Additionally, they had worse outcomes with a shorter duration of mechanical ventilation (p = 0.015) and lower survival rate at discharge (p = 0.024).

Conclusion Preterm birth and low birth weight are more common in CDH patients with twin pregnancy, which may lead to worse outcomes.

Keywords

congenital diaphragmatic hernia - twins - preterm birth - low birth weight - outcome
 

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