From The First Breath Of Life : congenital diaphragmatic hernia, the child at risk

Congenital diaphragmatic hernia (CDH) is a severe congenital anomaly of the diaphragm and both lungs, which occurs in approximately 1 per 2,500 births. Most CDH patients will have difficulty breathing directly after birth, and need immediate mechanical ventilatory support. Advanced postnatal treatment options with standardized treatment improved the survival outlook, even of CDH patients with most severe pulmonary hypoplasia and pulmonary hypertension.

This thesis describes the postnatal risks and short- and long-term outcomes of CDH patients from neonatal age until school age. Early outcomes include the risk of disturbed thyroid hormone concentrations during the neonatal period and the risk of persistent pulmonary hypertension in the first year of life. Long-term outcomes include the risk of neuropsychological problems and growth failure until school age. Six studies were performed in the Sophia Children’s Hospital in Rotterdam, the Netherlands (chapters 2, 3, 4, 7, and 8), and two in the Westmead Children’s Hospital in Sydney, Australia (chapters 5 and 6).