EC Paediatrics

Introduction: Congenital diaphragmatic hernia (CDH) consists of a posterolateral defect of the diaphragm, generally located on the left side, that allows passage of the abdominal viscera into the thorax. This study aimed to analyze the factors that influence the morbidity and mortality of patients with congenital diaphragmatic hernia.

Methods: We conducted an observational, descriptive, cross-sectional, and retrospective study, analyzing electronic health records of neonates admitted to the neonatal intensive care unit at Hospital para el Niño Poblano from January 2010 to December 2019. Statistical analysis involved measures of central tendency, Chi-square tests for nominal variables, and risk assessments.

Results: The incidence of CDH was 4.4 cases per year, with a mortality rate of 32% and a survival rate of 68%. Left posterolateral diaphragmatic hernia predominated, and echocardiography revealed significant associations between patent ductus arteriosus (PDA) and increased mortality. Surgical complications occurred in 15% of patients, with mortality primarily resulting from severe pulmonary hypertension, cardiogenic shock, and septic shock.

Discussion: The study identified significant associations between mortality and factors such as mode of delivery, positive pressure ventilation at birth, PDA, and severe pulmonary hypertension. Survival rates showed an inverse correlation with the severity of pulmonary hypertension.

Conclusion: The persistence of patent ductus arteriosus and severe pulmonary hypertension emerged as primary factors associated with increased mortality. Despite challenges, Hospital para el Niño Poblano maintained a commendable survival rate, underscoring the importance of a dynamic, multidisciplinary approach in neonatal care for CDH patients.

 Keywords: Congenital Diaphragmatic Hernia; Neonatal Intensive Care; Pulmonary Hypertension; Neonatal Mortality

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