{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:04:09Z","timestamp":1790643849257,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T00:00:00Z","timestamp":1675728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: Many prognostic factors for CDH patients are described and validated in the current literature: the size of diaphragmatic defects, need for patch repair, pulmonary hypertension and left ventricular dysfunction are recognized as the most influencing outcomes. The aim of this study is to analyze the influence of these parameters in the outcome of CDH patients in our department and identify any further prognostic factors. Methods: An observational retrospective single-center study was conducted including all patients treated at our centre with posterolateral CDH between 01.01.1997 and 12.31.2019. The main outcomes evaluated were mortality and length of hospital stay. A univariate and multivariate analysis was performed. Results: We identified 140 patients with posterolateral CDH; 34.8% died before discharge. The overall median length of stay was 24 days. A univariate analysis confirmed that both outcomes are associated with the size of diaphragmatic defects, need for patch repair and presence of spleen-up (p &lt; 0.05). A multivariate analysis identified that the need for patch repair and maximum dopamine dose used for cardiac dysfunction are independent parameters associated with the length of stay only (p &lt; 0.001). Conclusions: In our series, the duration of hospitalization is longer for newborns with CDH treated with higher doses of dopamine for left ventricular dysfunction or needing patch repair in large diaphragmatic defects.<\/jats:p>","DOI":"10.3390\/children10020315","type":"journal-article","created":{"date-parts":[[2023,2,8]],"date-time":"2023-02-08T03:01:45Z","timestamp":1675825305000},"page":"315","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Congenital Diaphragmatic Hernia: Perinatal Prognostic Factors and Short-Term Outcomes in a Single-Center Series"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0626-3309","authenticated-orcid":false,"given":"Camilla","family":"Pagliara","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Universitary Hospital of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-1708","authenticated-orcid":false,"given":"Elisa","family":"Zambaiti","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Universitary Hospital of Padova, 35128 Padova, Italy"},{"name":"Department of Pediatric Surgery, Paediatric Hospital of Torino, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3380-7145","authenticated-orcid":false,"given":"Giulia","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Universitary Hospital of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bonadies","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, Universitary Hospital of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costanza","family":"Tognon","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesiology, Universitary Hospital of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Salvadori","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care, Universitary Hospital of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Sgr\u00f2","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Universitary Hospital of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7175-3013","authenticated-orcid":false,"given":"Francesco Fascetti","family":"Leon","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Universitary Hospital of Padova, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1111\/jpc.12508","article-title":"Congenital diaphragmatic hernia","volume":"50","author":"Leeuwen","year":"2014","journal-title":"J. Paediatr. Child Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/j.1365-3016.2010.01172.x","article-title":"Epidemiology and outcome of congenital diaphragmatic hernia: A 9-year experience","volume":"25","author":"Wright","year":"2011","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5603\/GP.a2017.0005","article-title":"Congenital diaphragmatic hernia: Pathogenesis, prenatal diagnosis and management\u2014Literature review","volume":"88","year":"2017","journal-title":"Ginekol. Pol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1159\/000444210","article-title":"Standardized Postnatal Management of Infants with Congenital Diaphragmatic Hernia in Europe: The CDH EURO Consortium Consensus\u20142015 Update","volume":"110","author":"Snoek","year":"2016","journal-title":"Neonatology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jss.2019.05.007","article-title":"Toward Standardized Management of Congenital Diaphragmatic Hernia: An Analysis of Practice Guidelines","volume":"243","author":"Jancelewicz","year":"2019","journal-title":"J. Surg. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jpeds.2014.10.024","article-title":"Persistence of pulmonary hypertension by echocardiography predicts short-term outcomes in congenital diaphragmatic hernia","volume":"166","author":"Lusk","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1002\/pd.4789","article-title":"Myocardial effects of fetal endoscopic tracheal occlusion in lambs with CDH","volume":"36","author":"Zambaiti","year":"2016","journal-title":"Prenat. Diagn."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.jpedsurg.2003.12.006","article-title":"Cardiopulmonary anatomy and function in long-term survivors of mild to moderate congenital diaphragmatic hernia","volume":"39","author":"Stefanutti","year":"2004","journal-title":"J. Pediatr. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1007\/s00383-011-2925-1","article-title":"Patch repair is an independent predictor of morbidity and mortality in congenital diaphragmatic hernia","volume":"27","author":"Brindle","year":"2011","journal-title":"Pediatr. Surg. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/j.1471-0528.2004.00100.x","article-title":"Three-dimensional ultrasonographic assessment of fetal lung volume as prognostic factor in isolated congenital diaphragmatic hernia","volume":"111","author":"Ruano","year":"2004","journal-title":"BJOG"},{"key":"ref_11","first-page":"863","article-title":"Fetal lung volume measurement by magnetic resonance imaging in congenital diaphragmatic hernia","volume":"108","author":"Sonigo","year":"2001","journal-title":"BJOG"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1038\/jp.2011.3","article-title":"Echocardiographic measures of ventricular function and pulmonary artery size: Prognostic markers of congenital diaphragmatic hernia?","volume":"31","author":"Aggarwal","year":"2011","journal-title":"J. Perinatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s00383-009-2370-6","article-title":"Improvement in the outcome of patients with antenatally diagnosed congenital diaphragmatic hernia using gentle ventilation and circulatory stabilization","volume":"25","author":"Masumoto","year":"2009","journal-title":"Pediatr. Surg. Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1939","DOI":"10.7863\/ultra.32.11.1939","article-title":"New formulas for calculating the lung-to-head ratio in healthy fetuses between 20 and 40 weeks\u2019 gestation","volume":"32","author":"Kehl","year":"2013","journal-title":"J. Ultrasound Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Congenital Diaphragmatic Hernia Study Group (2001). Estimating disease severity of congenital diaphragmatic hernia in the first 5 minutes of life. J. Pediatr. Surg., 36, 141\u2013145.","DOI":"10.1053\/jpsu.2001.20032"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics Committee on Fetus and Newborn, and American College of Obstetricians and Gynecologists Committee on Obstetric Practice (2015). The APGAR Score. Pediatrics, 136, 819\u2013822.","DOI":"10.1542\/peds.2015-2651"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1055\/s-0035-1569151","article-title":"The Congenital Diaphragmatic Hernia Study Group Registry","volume":"25","author":"Morini","year":"2015","journal-title":"Eur. J. Pediatr. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.jpedsurg.2008.10.076","article-title":"The hidden mortality of congenital diaphragmatic hernia: A 20-year review","volume":"44","author":"Brownlee","year":"2009","journal-title":"J. Pediatr. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1007\/s00383-020-04634-y","article-title":"When primary repair is not enough: A comparison of synthetic patch and muscle flap closure in congenital diaphragmatic hernia?","volume":"36","author":"Nolan","year":"2020","journal-title":"Pediatr. Surg. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s00383-004-1226-3","article-title":"The relationship of diaphragmatic defect, liver growth, and lung hypoplasia in nitrofen-induced congenital diaphragmatic hernia in the rat","volume":"20","author":"Langwieler","year":"2004","journal-title":"Pediatr. Surg. Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.jpedsurg.2006.10.044","article-title":"Right congenital diaphragmatic hernia: An 18-year experience","volume":"42","author":"Midrio","year":"2007","journal-title":"J. Pediatr. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s13312-013-0276-9","article-title":"Presence of hernia sac in prediction of postoperative outcome in congenital diaphragmatic hernia","volume":"50","author":"Panda","year":"2013","journal-title":"Indian Pediatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1007\/s00247-018-04334-9","article-title":"Congenital diaphragmatic hernia sacs: Prenatal imaging and associated postnatal outcomes","volume":"49","author":"Oliver","year":"2019","journal-title":"Pediatr. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1002\/pd.5326","article-title":"Congenital diaphragmatic hernia has a better prognosis when associated with a hernia sac","volume":"38","author":"Bouchghoul","year":"2018","journal-title":"Prenat. Diagn."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1053\/j.sempedsurg.2014.09.008","article-title":"Congenital diaphragmatic hernia: Where and what is the evidence?","volume":"23","author":"Losty","year":"2014","journal-title":"Semin. Pediatr. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"151167","DOI":"10.1053\/j.semperi.2019.07.006","article-title":"Congenital diaphragmatic hernia-associated pulmonary hypertension","volume":"44","author":"Gupta","year":"2020","journal-title":"Semin. Perinatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1097\/PCC.0000000000002318","article-title":"Early Left Ventricular Dysfunction and Severe Pulmonary Hypertension Predict Adverse Outcomes in \u201cLow-Risk\u201d Congenital Diaphragmatic Hernia","volume":"21","author":"Dao","year":"2020","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1007\/s40268-014-0063-7","article-title":"Initial oxygenation response to inhaled nitric oxide predicts improved outcome in congenital diaphragmatic hernia","volume":"14","author":"Tiryaki","year":"2014","journal-title":"Drugs R&D"},{"key":"ref_29","first-page":"90","article-title":"Dopamine Use in Intensive Care: Are We Ready to Turn it Down?","volume":"4","author":"Marinosci","year":"2012","journal-title":"Transl. Med. UniSa"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"86","DOI":"10.3389\/fped.2018.00086","article-title":"Treating Hypotension in Preterm Neonates With Vasoactive Medications","volume":"6","author":"Joynt","year":"2018","journal-title":"Front. Pediatr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40748-017-0066-9","article-title":"Milrinone in congenital diaphragmatic hernia\u2014A randomized pilot trial: Study protocol, review of literature and survey of current practices","volume":"3","author":"Lakshminrusimha","year":"2017","journal-title":"Matern. Health Neonatol. Perinatol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/2\/315\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:27:06Z","timestamp":1760120826000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/2\/315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,7]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["children10020315"],"URL":"https:\/\/doi.org\/10.3390\/children10020315","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,7]]}}}