ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Neonatology
This article is part of the Research TopicNew Trends in Infant and Neonatal PulmonologyView all articles
Causes and risk factors for death in infants with congenital chylothorax
Provisionally accepted
Yuichi Kubo1*
Satoshi Ibara1Takuya Tokuhisa2Masaya Kibe3Kazuyoshi Sueyoshi2Masato Kamitomo2Motoi Kato4- 1Shonan Fujisawa Tokushukai Hospital, Kanagawa, Japan
- 2Kagoshima Shiritsu Byoin, Kagoshima, Japan
- 3Imakiire Sogo Byoin, Kagoshima, Japan
- 4Kagoshima Daigaku Byoin, Kagoshima, Japan
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Aim: To identify mortality risk factors in infants with congenital chylothorax (CC) and analyze the causes of death, including pathological examination. Methods: For this single-center retrospective study, we included 27 patients with CC. We divided them into the ALIVE and the DEAD groups, with the DEAD group subdivided into the Early-DEAD and the Late-DEAD groups to compare patient characteristics and risk factors using robust statistical methods. Causes of death were reviewed, including pathological findings from autopsies. Results: The mortality rate was 44% (12 of 27 infants, with 15 survivors). Univariate analysis showed associations between mortality and chromosomal abnormalities and fetal ascites. A longer duration of hydrothorax in utero was specifically associated with early neonatal death. Multivariate regression analysis identified fetal ascites as the strongest independent predictor of mortality. Pathological examination of six autopsied fatal cases revealed lymphangiectasia, including systemic lymphangiectasia in all five whole-body autopsies. Conclusion: Poor prognosis in infants with CC is strongly associated with fetal ascites, which we hypothesize serves as a key clinical marker for underlying Generalized Lymphatic Dysplasia (GLD). This systemic lymphatic disorder, identified pathologically as lymphangiectasia in fatal cases, may be the primary driver of mortality. Chromosomal abnormalities appear to be a significant predisposing factor for this severe phenotype.
Keywords: Congenital chylothorax, Cause of Death, Lymphangiectasia, Infant Mortality, Risk factors, Chromosome abnormalities
Received: 05 Sep 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Kubo, Ibara, Tokuhisa, Kibe, Sueyoshi, Kamitomo and Kato. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yuichi Kubo, kubo_u1@yahoo.co.jp
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.