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 an 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 an early term and 629 delivered at full term. The cumulative rate of survival to discharge showed no significant difference between CDH neonates delivered at an early term (395/515; 76.7%) or at full term (345/467; 73.9%) (risk ratio [RR] 1.01; 95% confidence interval [CI], 0.89–1.16; p = 0.85). Furthermore, the number of neonates requiring oxygen therapy at discharge was not significantly different between CDH neonates delivered at an early term (32/370; 8.6%) and at full term (14/154; 9.1%) (RR, 0.99; 95% CI, 0.36–2.70; p = 0.99). Therefore, the optimal timing of delivery at term for neonates with CDH remains unclear. Key points What's already known about this topic? The optimal timing of delivery at term to improve the prognosis of neonates with prenatally diagnosed congenital diaphragmatic hernia (CDH) remains controversial. What does this study add? Survival rates and need for oxygen therapy at discharge were not significantly different between neonates with CDH delivered at an early term and those delivered at full term. Therefore, there is insufficient evidence to determine the optimal timing of delivery at term.