Long-term outcomes beyond childhood in patients treated for congenital diaphragmatic hernia- a systematic review.

Abstract

Advancements in the management of congenital diaphragmatic hernia (CDH) have significantly improved survival rates, shifting the focus toward long-term outcomes in adult survivors. However, limited awareness of CDH sequelae among adult physicians complicates the transition from pediatric to adult care. This systematic review aims to provide a comprehensive evaluation of the most common long-term complications in CDH survivors aged 16 years and older following neonatal surgical repair. A literature search of PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Library was conducted according to PRISMA guidelines and registered on PROSPERO. Nineteen studies met inclusion criteria, encompassing 250 adult survivors (mean age: 22.1 years). Chronic lung disease was observed in 33% of patients, with 28% experiencing dyspnea during daily activities and exertion. Gastroesophageal reflux disease (GERD) was present in 45%, and severe scoliosis was identified in 2.4%. Quality of life was generally reported as good, though 30% experienced depression and lower scores in vitality and mental health domains. CDH survivors frequently encounter multisystem morbidities, including pulmonary, gastrointestinal, and musculoskeletal challenges. Structured transition programs and multidisciplinary follow-up are essential to address these needs and ensure continuity of care into adulthood. Further research is warranted to optimize outcomes and develop standardized protocols for this growing population.