ArticleFrontiers in pediatrics2025
Early assessment and analysis of high-risk factors of neurodevelopmental impairment in neonates with congenital diaphragmatic hernia.
Article in Frontiers in pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: This study aimed to retrospectively analyze clinical data of neonates with congenital diaphragmatic hernia (CDH) to investigate risk factors for neurodevelopmental impairment and their prognosis, and to evaluate the predictive value of combined assessment using amplitude-integrated electroencephalography (aEEG), regional cerebral oxygen saturation (rSO₂), and Neonatal Behavioral Neurological Assessment ( Methods: A total of 83 neonates with CDH (36 in the neurodevelopmental impairment group and 47 in the control group) were included, all diagnosed by prenatal ultrasound and postnatal imaging, with exclusion of other congenital malformations, hemodynamic instability, and genetic disorders. Clinical data [e.g., lung-to-head ratio (LHR), postoperative pulmonary hypertension, surgical approach], neuromonitoring indices (aEEG, rSO₂), and neurodevelopmental assessments (NBNA, Gesell Developmental Schedules) were collected. Independent risk factors for neurodevelopmental impairment and the area under the ROC curve (AUC) of aEEG, rSO₂, NBNA, and their combined assessment were analyzed. Results: Severe pulmonary hypoplasia (LHR < 1.5; OR = 6.20, 95% CI: 2.15-17.80, Conclusion: LHR < 1.5, PPHN, and open surgery are independent predictors of neurodevelopmental impairment in CDH neonates. The combined use of aEEG, rSO₂, and NBNA significantly improves the efficiency of early neurodevelopmental impairment identification (AUC = 0.960), outperforming single indicators. Clinicians should prioritize monitoring pulmonary hypoplasia and perinatal complications while adopting multimodal neuromonitoring to optimize early intervention strategies.
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