Objective To analyze the risk factors and prognosis of brain injury in neonates with congenital diaphragmatic hernia (CDH), in order to provide evidence for clinical prediction and intervention. Methods A retrospective analysis was conducted on 83 full-term CDH neonates who underwent surgical treatment at the Second Affiliated Hospital of Xi′an Jiaotong University from October 2019 to August 2023.Based on diagnostic criteria for brain injury syndrome, patients were divided into a brain injury group (n=36) and a control group (n=47).General neonatal data, perinatal records, comorbidities, and examination Results were compared between the two groups.Logistic regression analysis was used to identify high-risk factors for brain injury. Results Significant differences were observed between the brain injury and control groups in lung-to-head ratio (LHR) (t=4.335), open surgery (χ2=4.196), and pulmonary hypertension (χ2=5.397) (P<0.05).Logistic regression identified the following independent risk factors for brain injury: lung-to-head ratio <1.5 (OR=8.171, 95%CI: 2.893 - 23.079, P<0.001), pulmonary hypertension (OR=4.069, 95%CI: 1.129 - 14.674, P=0.032), and open surgery (OR=3.517, 95%CI: 0.952 - 12.987, P<0.1).Among the 36 brain injury cases, 1 died, 2 were lost to follow-up, 24 had favorable outcomes, and 9 had poor prognosis. Conclusions Lung-to-head ratio <1.5, pulmonary hypertension, and open surgery significantly increase the risk of brain injury in CDH neonates.Intensive monitoring and targeted interventions should be implemented for high-risk patients to improve prognosis.
Key words
congenital diaphragmatic hernia /
brain injury /
lung-to-head ratio /
surgical approach /
neonates
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