Infant Survival From Birth Defect

Congenital Diaphragmatic Hernia is a birth defect that occurs when the diaphragm does not fully form, allowing organs to enter the chest cavity preventing lung growth. The condition happens in 1 of every 2,500 babies born. Half of the babies born with CHD do not survive. A new study finds infants who are born after their due date are more likely to survive with treatment than those born earlier.

Half of the babies born with CHD are treated with extracorporeal membrane oxygenation. ECMO is a machine that takes over the work of the infant’s heart and lungs. Researchers from the University of Rochester conducted a study comparing survival rates of infants who received ECMO born early and those born late.

Researchers used a database of information on infants born with CHD between 1976 and 2001. They compared survival of infants born early term (38 to 39 weeks gestation) to infants born late term (40 to 41 weeks gestation).

The study determined the infants who were born later were more likely to survive than those born earlier. The infants born after 40 weeks were also more likely to spend less time on ECMO and less time in the hospital. Researchers also report that since the 1980s, the survival rate decreased from 63 percent to 52 percent. The lower survival rate was associated with an increase in prenatal diagnosis, early term delivery, lower birth rate, longer time on ECMO and more complications.

Researchers say the survival rates for infants could be improved if delivery of babies is delayed until after 40 weeks gestation. They add recent trends toward prenatal diagnosis may be responsible for higher numbers of early term births putting these infants at higher risk of death.

SOURCE: Pediatrics, 2002