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Is antenatal corticosteroids intervention benefit for left-sided congenital diaphragmatic hernia? --A multicenter retrospectively study
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  • Bo Xia,
  • Qiuming He,
  • Jing Tang,
  • Zhe Wang,
  • Jun-Jian Lv,
  • Gang Yu
Bo Xia
Guangzhou Women and Children’s Medical Center

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Qiuming He
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Jun-Jian Lv
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Objective To determine the effects of antenatal corticosteroids treatment for congenital diaphragmatic hernia (CDH). Design A multicenter retrospectively study Setting Guangzhou Women and Children’s Medical Center, Guangdong Women and Children Hospital, Third Affiliated Hospital of Guangzhou Medical College. Methods Antenatal corticosteroids treatment was administered by intramuscular injection to mothers at 32 weeks of gestation (5mg twice a day for two days) depending of the clinical course and attending physician. Patients were divided into the observe group (39 cases) and the control group (40 cases). Main outcome measures Primary outcome was mortality. Secondary outcome was pulmonary arterial hypertension (PAH) Results: 79 cases (50 male and 29 females) were enrolled at 3 center. Of note, there was no significant difference in prenatal evaluation and the severity of PAH between this two group. The mortality of this two group was 17.% and 38.5% respectively (P=0.038). Observe group was associated with a lower survival(OR=0.3,95% CI=0.1-1.0, P=0.042). After adjusting for potential confounders, prenatal corticosteroids treatment was associated with a lower survival (OR=0.7, 95% CI=0.1 to 3.8, p=0.640). Conclusion Antenatal corticosteroids treatment cannot improve the severity of PAH, nor improve the mortality. Instead,Antenatal corticosteroids treatment have been linked to increased mortality. Therefore, Antenatal corticosteroids treatment cannot be recommended in this data. Funding This study was supported by Guangdong Basic and Applied Basic Research Foundation, 2020A1515010296 Key words Congenital diaphragmatic hernia, prenatal corticosteroids intervention, mortality, pulmonary arterial hypertension Tweetable abstract Antenatal corticosteroids treatment seems cannot improve prognosis in patients with CDH.