Our Summary

This study looked at the health outcomes of babies who were born with a low birthweight (under 2.5kg) and a congenital diaphragmatic hernia (CDH), a birth defect where the diaphragm doesn’t form properly.

The researchers compared these babies to those of a normal birthweight but also with CDH, over an 11 year period.

They found that those with a low birthweight were more likely to have other birth defects and had larger diaphragmatic defects. They also found that these babies were less likely to use extracorporeal life support, a life-saving technique that uses a machine to take over the work of the lungs.

Sadly, these low birthweight babies also had a higher mortality rate. For each kilogram increase in birthweight, the chances of survival after surgery to repair the CDH increased by 34%.

Additionally, low birthweight babies needed to be on a ventilator for longer and were more likely to still need extra oxygen after 30 days and when they were discharged from the hospital.

Overall, this suggests that being born with a low birthweight is a risk factor for death and lung problems in babies with CDH. It also implies that these babies will likely need longer hospital stays and more medical support.

FAQs

  1. What is a congenital diaphragmatic hernia (CDH)?
  2. How does low birthweight affect the health outcomes of babies with CDH?
  3. What is the survival rate after surgery to repair the CDH in low birthweight babies?

Doctor’s Tip

Therefore, it is important for parents to work closely with their healthcare team to monitor and manage their baby’s health closely after CDH repair surgery. This may include regular follow-up appointments, ongoing monitoring of lung function, and potentially additional support such as physical therapy or respiratory therapy.

It is also important for parents to be aware of the potential challenges their baby may face due to their low birthweight and to seek support and guidance from their healthcare team as needed. By staying informed and proactive, parents can help ensure the best possible outcome for their baby after CDH repair surgery.

Suitable For

Patients who are typically recommended congenital diaphragmatic hernia repair are those who are born with a diaphragmatic hernia, regardless of birth weight. However, as this study suggests, babies with a low birth weight may face additional challenges and have a higher risk of mortality and complications following surgery for CDH. These babies may require more intensive medical support and longer hospital stays compared to those with a normal birth weight. It is important for healthcare providers to carefully evaluate each individual case and provide appropriate care and support for babies with CDH, especially those with a low birth weight.

Timeline

Before congenital diaphragmatic hernia repair, a patient may experience symptoms such as difficulty breathing, rapid breathing, bluish skin color, and a visible lump in the chest or abdomen. They may also undergo diagnostic tests such as ultrasounds, X-rays, and MRIs to confirm the diagnosis of CDH.

After congenital diaphragmatic hernia repair, a patient will likely need to be closely monitored in the intensive care unit for respiratory support, pain management, and to prevent complications such as infections. They may require a ventilator to help with breathing and may need additional surgeries or procedures to repair any other associated birth defects. Physical therapy and rehabilitation may also be needed to help the patient recover and regain strength. Follow-up appointments with healthcare providers will be necessary to monitor the patient’s progress and address any ongoing concerns.

What to Ask Your Doctor

Some questions a patient may want to ask their doctor about congenital diaphragmatic hernia repair include:

  1. What are the potential risks and complications associated with the surgery to repair the diaphragmatic hernia?
  2. How long is the recovery process expected to be for my baby after the surgery?
  3. Will my baby need to be on a ventilator or require extra oxygen after the surgery, and if so, for how long?
  4. Are there any long-term effects or complications that my baby may experience as a result of having a congenital diaphragmatic hernia?
  5. Will my baby require any additional treatments or therapies after the surgery to help with their recovery and overall health?
  6. What is the success rate of the surgery for repairing a congenital diaphragmatic hernia in babies with low birthweight compared to those with a normal birthweight?
  7. How often will my baby need follow-up appointments or monitoring after the surgery to ensure their health and well-being?
  8. Are there any specific precautions or guidelines I should follow to help support my baby’s recovery and overall health after the surgery?
  9. Are there any support groups or resources available for families of babies with congenital diaphragmatic hernia to help navigate the treatment process and provide emotional support?
  10. Is there anything else I should know or consider regarding my baby’s condition and treatment plan for congenital diaphragmatic hernia repair?

Reference

Authors: Gupta VS, Ferguson DM, Lally PA, Garcia EI, Mitchell KG, Tsao K, Lally KP, Harting MT; Congenital Diaphragmatic Hernia Study Group. Journal: J Matern Fetal Neonatal Med. 2022 Dec;35(25):6823-6829. doi: 10.1080/14767058.2021.1926448. Epub 2021 May 16. PMID: 33998394