ObjectiveTo evaluate medium‐term self‐reported respiratory and gastrointestinal (GI) outcomes in children with congenital diaphragmatic hernia (CDH).DesignSelf‐reported respiratory and GI outcomes correlated with prenatal severity indicators.SettingProspective study at three fetal medicine units.PopulationFamilies of children prenatally diagnosed with isolated, left‐sided CDH surviving for >1 year.MethodsFamilies received validated questionnaires for GI outcomes (Infant Gastroesophageal Reflux Questionnaire Revised, I‐GERQ‐R, for infants aged <2 years, or Paediatric Gastro‐oesophageal Symptom and Quality of Life Questionnaire, PGSQ, for children aged aged 2‐8 years or >9 years) and respiratory outcomes (preschool respiratory outcome questionnaire, for children aged ≤5 years, or the International Study of Asthma and Allergies in Childhood asthma questionnaire, for children aged 6–8 years or ≥9 years). Prenatal data collected from the medical records included lung size (percentage observed/expected lung‐to‐head ratio, O/E LHR %), liver position, fetal endoluminal tracheal occlusion (FETO) gestational age (GA) at delivery, and perinatal data included birthweight, location, patch repair and respiratory support.Main outcome measuresThe GI and respiratory scores were correlated with O/E LHR using linear and logistic regression models. Univariate analysis was used to evaluate associations with perinatal variables.ResultsWe obtained 142 responses from 342 families (representing a response rate of 45%). The baseline characteristics of participants and non‐participants were comparable. No correlations between perinatal variables and respiratory or GI scores were identified. Children aged ≤5 years with lower O/E LHR values reported higher respiratory scores (P = 0.0175); this finding was not reported in older children. Overall, the children who underwent FETO (n = 51) had GI (P = 0.290) and respiratory (P = 0.052) scores that were comparable with those of children who were expectantly managed.ConclusionsFamilies and children with prenatally diagnosed CDH reported fewer respiratory symptoms with increasing age. There was no correlation between O/E LHR or the use of FETO and self‐reported outcomes.

中文翻译：

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孤立性先天性膈疝儿童自我报告的呼吸和胃肠道结局：一项前瞻性多中心研究


目的评估先天性膈疝（CDH）儿童中期自我报告的呼吸和胃肠道（GI）结局。设计自我报告的呼吸和胃肠道结局与产前严重程度指标的相关性。在三个胎儿医学单位进行前瞻性研究。人群产前儿童家庭被诊断为孤立性左侧 CDH 且存活时间 > 1 年。 方法 家庭接受了经过验证的胃肠道结果调查问卷（针对 2 岁以下婴儿的婴儿胃食管反流问卷修订版，I-GERQ-R，或儿童胃食管症状和质量生活问卷 (PGSQ)，适用于 2‐8 岁或 >9 岁的儿童）和呼吸系统结果（学前呼吸结果问卷，适用于 ≤5 岁的儿童，或国际哮喘和儿童过敏研究哮喘问卷，适用于 2-8 岁儿童） 6-8 年或≥9 年）。从医疗记录中收集的产前数据包括肺大小（观察到的/预期的肺与头比率的百分比，O/E LHR %）、肝脏位置、胎儿腔内气管闭塞（FETO）、分娩时的孕龄（GA）和围产期数据包括出生体重、位置、补片修复和呼吸支持。主要结果指标使用线性和逻辑回归模型将 GI 和呼吸评分与 O/E LHR 相关。使用单变量分析来评估与围产期变量的关联。结果我们获得了来自 342 个家庭的 142 份答复（答复率为 45%）。参与者和非参与者的基线特征具有可比性。未发现围产期变量与呼吸或胃肠道评分之间存在相关性。 O/E LHR 值较低的 ≤5 岁儿童报告呼吸评分较高（P = 0.0175）；在年龄较大的儿童中没有报道这一发现。总体而言，接受 FETO 的儿童 (n = 51) 的胃肠道评分 (P = 0.290) 和呼吸系统评分 (P = 0.052) 与接受期待治疗的儿童相当。 结论 产前诊断为 CDH 的家庭和儿童报告的呼吸道症状较少随着年龄的增长。 O/E LHR 或 FETO 的使用与自我报告的结果之间没有相关性。