Growth Restriction Beginning in Early Infancy Among Survivors of Congenital Diaphragmatic Hernia: A Single-Center Experience

A significant number of congenital diaphragmatic hernia (CDH) survivors experience growth restriction (GR), but the timing of its onset is not well studied. This single-center retrospective study evaluated the frequency of GR at specific postnatal ages and associated risk factors. We reviewed charts of prenatally diagnosed CDH patients delivered between 2011 and 2020, with follow-up until December 2022. Body height and weight Z-scores were assessed at 1, 2, 3, 6, 12, 18, and 36 months of age. GR, defined as a Z-score below -2.0, was observed in 32%, 63%, 50%, 50%, 48%, 42%, and 24% of patients at these ages, respectively. Persistent GR up to 6 months was associated with lower birth weights, pulmonary vasodilator use at discharge, and asthma after discharge. GR begins in early infancy in CDH survivors but improves over time with catch-up growth, highlighting the need for long-term growth monitoring and nutritional/respiratory support after discharge.