Maternal and Gestational Risk Factors of Congenital Diaphragmatic Hernia

Sophie Noelle Hackenbruch, Gabriella Grima, Edith Said

Abstract

Background and Aim: The incidence of congenital diaphragmatic hernias (CDHs) is high in the Maltese islands, but little is known about their association with maternal risk factors. A nationwide study in a country where abortion is still illegal allowed access to more data. This study was conducted to shed light on the possible risk factors in the development of CDH.

Materials and Methods: This population-based, retrospective study assessed the data of CDH cases from 1993 to 2016, which were collected from the Directorate of Health Information and Research (Malta). χ2 test was done to examine the associations between the cases and controls.

Results: Between 1993 and 2016, 55 cases of CDH were reported. The cases made up 0.0644% of the total births during that period. Advanced maternal age was more likely in CDH cases (P = .01). In 18.2% of the neonates with CDH, the birth weight was 1500 to 2499 g, while only 6.2% of the control group neonates had a birth weight in this range (P < .001). There was no statistically significant association between CDH (54.5%) and the neonates’ sex (50.9%) (P = .404) and CDH (3.6%) and plural births (1.3%) (P = .333).

Conclusions: CDH was found to be associated with advanced maternal age and low birth weight. Also, CDH increases the risk of other congenital anomalies.