Abstract：
BACKGROUND: Pulmonary hypertension (PHTN) causes significant morbidity and mortality in patients with congenital diaphragmatic hernia (CDH). Currently, there is no routinely obtained prenatal prognostic marker to reliably predict postnatal CDH-associated PHTN severity.
METHODS: The CDH Study Group (CDHSG) registry was queried for infants born from 2015 to 2021 with a graded (1-4) PHTN diagnosis. Fetal observed-to-expected lung volume to head circumference ratio (o/e LHR), percent predicted lung volume (PPLV), and total lung volume (TLV) were classified by severity.
RESULTS: Of 4056 patients, 1047 and 785 infants had prenatal ultrasound or magnetic resonance imaging, respectively. Both moderate and severe o/e LHR were associated with increased odds of postnatal development of moderate (OR 2.913) and severe PHTN (OR 4.924).
CONCLUSIONS: In infants with CDH, prenatal predictor severity was associated with higher severity of PHTN and increased ECLS usage. Overall, patients with worse prenatal prognostic indicators were less likely to receive pulmonary vasodilator treatment.
METHODS: The CDH Study Group (CDHSG) registry was queried for infants born from 2015 to 2021 with a graded (1-4) PHTN diagnosis. Fetal observed-to-expected lung volume to head circumference ratio (o/e LHR), percent predicted lung volume (PPLV), and total lung volume (TLV) were classified by severity.
RESULTS: Of 4056 patients, 1047 and 785 infants had prenatal ultrasound or magnetic resonance imaging, respectively. Both moderate and severe o/e LHR were associated with increased odds of postnatal development of moderate (OR 2.913) and severe PHTN (OR 4.924).
CONCLUSIONS: In infants with CDH, prenatal predictor severity was associated with higher severity of PHTN and increased ECLS usage. Overall, patients with worse prenatal prognostic indicators were less likely to receive pulmonary vasodilator treatment.
摘要：
背景：肺动脉高压（PHTN）导致先天性膈疝（CDH）患者的高发病率和高死亡率。目前,没有常规获得的产前预后标志物来可靠地预测出生后CDH相关的PHTN严重程度.
方法：在CDH研究组（CDHSG）注册中查询了2015年至2021年出生的婴儿（1-4级）PHTN诊断。胎儿观察到的预期肺容积与头围之比（o/eLHR），预测肺容积百分比(PPIV)，和肺总容积（TLV）按严重程度分类。
结果：在4056名患者中，1047和785名婴儿进行了产前超声或磁共振成像，分别。中度和重度o/eLHR均与中度（OR2.913）和重度PHTN（OR4.924）的产后发展几率增加有关。
结论：在患有CDH的婴儿中，产前预测因子严重程度与PHTN严重程度升高和ECLS使用率增加相关.总的来说,产前预后指标较差的患者接受肺血管扩张治疗的可能性较小.
方法：在CDH研究组（CDHSG）注册中查询了2015年至2021年出生的婴儿（1-4级）PHTN诊断。胎儿观察到的预期肺容积与头围之比（o/eLHR），预测肺容积百分比(PPIV)，和肺总容积（TLV）按严重程度分类。
结果：在4056名患者中，1047和785名婴儿进行了产前超声或磁共振成像，分别。中度和重度o/eLHR均与中度（OR2.913）和重度PHTN（OR4.924）的产后发展几率增加有关。
结论：在患有CDH的婴儿中，产前预测因子严重程度与PHTN严重程度升高和ECLS使用率增加相关.总的来说,产前预后指标较差的患者接受肺血管扩张治疗的可能性较小.
