{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T19:42:27Z","timestamp":1788810147713,"version":"build-2803163510"},"reference-count":31,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Introduction:&lt;\/i&gt;&lt;\/b&gt; The aim of this study was to evaluate prediction of neonatal mortality in fetuses with isolated left congenital diaphragmatic hernia (CDH) when the observed\/expected lung-to-head ratio (O\/E LHR) was estimated at two different gestational time points during pregnancy. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; Forty-four (44) fetuses with isolated left CDH were included. O\/E LHR was estimated at the time of referral (first scan) and before delivery (last scan). The main outcome was neonatal death due to respiratory complications. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; There were 10\/44 (22.7%) perinatal deaths. The areas under (AU) the ROC curves were: first scan, 0.76, best O\/E LHR cut-off 35.5% with 76% sensitivity and 70% specificity; last scan, AU-ROC 0.79, best O\/E LHR cut-off 35.2%, with 79.0% sensitivity and 80% specificity. Considering an O\/E LHR cut-off \u226435% to define high-risk fetuses at any examination, prediction for perinatal mortality showed: 80% sensitivity, 73.5% specificity, 47.1% positive and 92.6% negative predictive values, and 3.02 (95% CI 1.59\u20135.73) positive and 0.27 (95% CI 0.08\u20130.96) negative likelihood ratios. Prediction was similar in the two evaluations as 16\/21 (76.2%) of fetuses considered at risk had an O\/E LHR \u226435% in the two examinations; in the remaining 5 cases, two were identified only in the first and three only in the last scan. &lt;b&gt;&lt;i&gt;Conclusion:&lt;\/i&gt;&lt;\/b&gt; The O\/E LHR is a good predictor of perinatal death in fetuses with left isolated CDH. Approximately 80% of fetuses at risk of perinatal death can be identified with an O\/E LHR \u226435%, and 90% of them will have similar O\/E LHR values at the first and at the last ultrasound examinations prior to delivery. In general, 88.6% of all CDH fetuses have a similar severity classification based on the O\/E LHR at the first diagnostic ultrasound or at the ultrasound examination prior to delivery. <\/jats:p>","DOI":"10.1159\/000531406","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T06:58:00Z","timestamp":1691477880000},"page":"438-445","source":"Crossref","is-referenced-by-count":7,"title":["Does Prediction of Neonatal Mortality by the Observed\/Expected Lung-To-Head Ratio Change during Pregnancy in Fetuses with Left Congenital Diaphragmatic Hernia?"],"prefix":"10.1159","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-6640","authenticated-orcid":false,"given":"Erin 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