Purpose.

To evaluate correlation between fetal lung volume indices and mortality rate in postnatal period with determination the most prognostically valuable methods.

Materials and methods. Prospective study based on analysis of MR-imaging and surgical treatment or autopsy data of 71 newborns with congenital diaphragmatic hernia (CDH). All pregnant women underwent MRI to determine the lung to thorax volume ratio (TLV/ThV), lung to fetal body volume ratio (TLV / FBV), observed to expected lung volume (o/e TLV). Roc-curves were performed. Correlation analysis with postnatal data was carried out.

Results. With o/e TLV, Meyers less than 25%, the mortality rate was 91.7%, with TLV/FBV<0.011 - 80.0%, with TLV/ThV<15% - 77.8%. ROC-AUC for o/e TLV ranged from 0.760 (Meyers et al) to 0.794 (Osada et al), for TLV/FBV - 0.725, for TLV/ThV - 0.789. Among survivors negative correlation was found between TLV/ThV and days at the time of enteral feeding (nasogastric tube) (r = -0.554, p <0.001). For TLV/FBV negative correlation was found with the number of days at the time of full enteral feeding (r = -0.550, p <0.001) and the number of bed-days (r = -0.501, p = 0.001). For o/e TLV, Meyers there was negative correlation with days at the time of withdrawal oxygen supply (r = -0.565, p <0.001), extubation (r = -0.587, p <0.001), switching to enteral nutrition (nasogastric tube) (r = -0.654, p <0.001), full enteral feeding (r = -0.716, p <0.001) and number of bed-days (r = -0.626, p <0.001).

Conclusions. Findings suggest to use lung volume indices as predictors of mortality and severity in newborns with CDH.