Prenatal Prediction of Delayed Abdominal Closure in Isolated Congenital Diaphragmatic Hernia Using Observed-to-Expected Lung-to-Head Ratio.

Objective: O/E LHR is a well-established prenatal severity marker in congenital diaphragmatic hernia (CDH), but its capacity to predict the postnatal need for delayed abdominal wall closure (DAC) remains undefined. We aimed to determine its predictive capacity. Method: Retrospective analysis of neonates with isolated left-sided CDH (2015-2026), comparing primary closure with DAC. Discriminative capacity was assessed by ROC analysis and the optimal cut-off was determined by bootstrap-aggregated approach. Logistic regression estimated univariate and liver herniation adjusted multivariate odds ra

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