Predictors of Mortality and Morbidity in Infants with CDH

Congenital diaphragmatic hernia (CDH) accounts for 8% of all major congenital anomalies with an incidence of 1 in 2000 to 4000 births (Doyle & K.P. Lally 2004). It is associated with significant mortality and morbidity (Abdullah et al., 2009). Survival data for CDH are conflicting; a few centers reported 82% to 93% survival rate (Javid et al., 2004; Grushka et al., 2009; Mettauer et al., 2009) while others had significantly less figures (54%-56%) (Colvin et al., 2005; Levison et al., 2006). This divergence in survival data has been attributed to case selection bias at single tertiary care institutions because as many as 35% of live-born infants with CDH do not survive to transport resulting in a hidden mortality for this condition (Harrison et al., 1978; Colvin et al.; 2005, V.K. Mah et al., 2009). Hidden mortality is referred to patients who die before surgery, either during gestation or shortly after birth, and thus are not reported by individual institutions (Harrison et al., 1994).