The effect of musculoskeletal abnormalities on lung function in children born with congenital diaphragmatic hernia.

BACKGROUND

Chest wall deformities (CWD) and scoliosis are common comorbidities in congenital diaphragmatic hernia (CDH) survivors. Their effects on lung function remain unclear.

METHODS

We retrospectively analysed 184 CDH patients treated in our clinic between 1999 and 2025, of whom 166 (90.2%) survived until discharge. We matched patients with varying degrees of musculoskeletal abnormalities to controls from our cohort and compared spirometry data.

RESULTS

6.7% of patients had scoliosis and 57.9% had CWD, most commonly asymmetry of the chest (46.4%) and pectus excavatum (42.1%). CWD were usually ipsilateral (95.4%) but the convexity of scoliosis varied. 5/12 scoliosis patients received treatment, and none of the CWD patients. Moderate CWD was associated with lower forced vital capacity in univariate (Z-score effect size -2.08, p < 0.01) and multivariate (-1.53, p = 0.015) analyses.

CONCLUSIONS

Chest wall deformities are common in children born with congenital diaphragmatic hernia. More severe chest wall deformities in CDH were associated with a lower forced vital capacity.