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Eur J Pediatr Surg 2020; 30(01): 039-044
DOI: 10.1055/s-0039-1698767
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Asthma Medication Use in Congenital Diaphragmatic Hernia Survivors: A Retrospective Population Level Data Analysis

Authors

  • Matthew Levesque

    1   Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada

  • Suyin A. Lum Min

    1   Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada

  • Melanie I. Morris

    1   Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada

  • Anna C. Shawyer

    1   Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada

  • Richard Keijzer

    1   Department of Surgery, Division of Pediatric Surgery, University of Manitoba and Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada

Funding This study was funded by the Children's Hospital Research Institute of Manitoba, (Grant/Award Number: OG2017-07) and Thorlakson Chair in Surgical Research.
Further Information

Publication History

15 May 2019

02 September 2019

Publication Date:
10 November 2019 (online)

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Abstract

Introduction The purpose of this study was to determine if congenital diaphragmatic hernia (CDH) survivors had worse long-term respiratory outcomes compared with age-matched controls, as measured by inhaled bronchodilator use, inhaled steroid use, and asthma-related physician visits.

Materials and Methods We performed a retrospective case-control study of infants with isolated CDH from 1991 to 2013. The primary outcome measures were inhaled bronchodilator prescriptions, inhaled steroid prescriptions, and asthma-related physician visits between 0 and 5 years of age and between 5 and 10 years of age. Subgroup analysis compared the same outcomes for CDH patients grouped by: birth weight, gestational age, side of defect, defect size, liver herniation, hernia sac, and pulmonary hypertension.

Results Fifty-six patients with CDH and 753 age-matched controls met the inclusion criteria for the 0 to 5 years of age analysis. Between 0 and 5 years of age, more CDH survivors were prescribed an inhaled bronchodilator (odds ratio [OR] = 2.47[1.38–4.48], p = 0.001) and inhaled steroid (OR = 2.03[1.07–3.74], p = 0.03), and had an asthma-related physician visit (OR = 1.92[1.00–3.56], p = 0.04). Thirty-eight cases and 491 controls met the inclusion criteria for the 5 to 10 years of age analysis. Between 5 and 10 years of age, CDH survivors were not more likely to be prescribed inhaled bronchodilators, inhaled steroids, or have an asthma-related physician visit. Among the CDH patients, we did not find a clinical characteristic associated with increased inhaled bronchodilator or steroid prescriptions at any age.

Conclusion A history of CDH is associated with higher rates of inhaled bronchodilator prescriptions, inhaled steroid prescriptions, and asthma-related physician visits from 0 to 5 years of age compared with age-matched controls. However, this difference resolves by 5 to 10 years of age.

Keywords

congenital diaphragmatic hernia - long-term outcomes - respiratory outcomes