Neonatal outcomes of congenital diaphragmatic hernia in full term versus early term deliveries: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to review the optimal timing of delivery at term for neonates with prenatally diagnosed congenital diaphragmatic hernia (CDH). We reviewed the literature up to December 19, 2022 using MEDLINE and the Cochrane Library databases. The inclusion criteria were original articles, comparative studies of CDH neonates delivered at early term (37-38 weeks of gestation) and at full term (39 weeks of gestation or later), and comparative studies investigating outcomes of CDH neonates. Six studies met the inclusion criteria, including 985 neonates delivered at early term and 629 delivered at full term. The cumulative rate of survival to discharge showed no significant difference between CDH neonates delivered at early term (395/515; 76.7%) or at full term (345/467; 73.9%) (risk ratio 1.01; 95% confidence interval, 0.89-1.16; p = 0.85). Further, the number of neonates requiring oxygen therapy at discharge was not significantly different between CDH neonates delivered at early term (32/370; 8.6%) and at full term (14/154; 9.1%) (risk ratio, 0.99; 95% confidence interval, 0.36-2.70; p = 0.99). Therefore, the optimal timing of delivery at term for neonates with CDH remains unclear. This article is protected by copyright. All rights reserved.