Abstract :
Keywords Congenital diaphragmatic hernia; Neurodevelopmental outcome; Prenatal diagnosis; Predictive parameter Highlights * Congenital diaphragmatic hernia (CDH) has high mortality and long-term morbidity. * Lung to thorax transverse area ratio (LTR) represents fetal pulmonary hypoplasia. * LTR predicted the mortality but not neurodevelopmental outcomes in fetuses with CDH. Abstract Introduction Infants with congenital diaphragmatic hernia (CDH) are at risk of neurodevelopmental disabilities. This study aimed to investigate the association between lung to thorax transverse area ratio (LTR) and neurodevelopmental outcomes at 3 years of age in fetuses with CDH. Methods We performed a retrospective study of infants with prenatally diagnosed isolated left-sided CDH born in Kyushu University Hospital between 2008 and 2016. We examined the association between prenatal ultrasound findings including LTR and development quotient (DQ) at 36 to 42 months of chronological age. Results We identified 34 live-born fetuses with isolated left-sided CDH, of which 30 survived and four died before discharge. The median LTR in the survivors was higher than in the non-survivors (p Conclusion In fetuses with isolated left-sided CDH, prenatal LTR predicts the mortality but not neurodevelopmental outcomes at 3 years of age. Abbreviations CA, Cognitive-adaptive; CDH, Congenital diaphragmatic hernia; DQ, Development quotient; ECMO, Extracorporeal membrane oxygenation; KSPD, Kyoto Scale of Psychological Development; LHR, Lung area to head circumference ratio; LS, Language-social; LTR, Lung to thorax transverse area ratio; NO, Nitric oxide; o/eLHR, Observed/expected lung area to head circumference ratio; PM, Postural-motor; PPHN, Persistent pulmonary hypertension of the newborn Author Affiliation: (a) Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (b) Department of Pediatric Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan (c) Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan * Corresponding author at: Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Article History: Received 26 December 2021; Revised 20 May 2022; Accepted 1 June 2022 Byline: Toru Sawano (a), Takuya Kondo (b), Go Ebihara (a), Kouji Nagata (b), Hirosuke Inoue [hinoue@pediatr.med.kyushu-u.ac.jp] (a,*), Junko Fujiyoshi (a), Masayuki Ochiai (a), Saki Kido (c), Yasuyuki Fujita (c), Yasunari Sakai (a), Kiyoko Kato (c), Tatsuro Tajiri (b), Shouichi Ohga (a)