Survival of infants with congenital diaphragmatic hernia in California: impact of hospital, clinical, and sociodemographic factors.

ABSTRACT: OBJECTIVE:To understand factors associated with care and survival among babies with congenital diaphragmatic hernia (CDH). STUDY DESIGN:We used data on California births (2006-2011) to examine birth hospital level of care, hospital transfer before repair, and survival. RESULT:Among 577 infants, 25% were born at lower-level hospitals, 62% were transferred, and 31% died during infancy. Late or no prenatal care had the strongest association with birth at lower-level hospitals (adjusted relative risk (ARR)?=?1.9, 95% confidence interval (CI)?=?1.0-3.6). Birth at lower-level hospitals was associated with transfer (ARR?=?1.2, CI?=?1.1-1.4), and transferred infants tended to be less clinically complex. Infants with low birthweight, other birth defects, low Apgar scores, and late or no prenatal care had two- to fourfold higher risk of mortality than their comparison groups. CONCLUSIONS:These data support the importance of prenatal care and delivery planning into higher-level hospitals for optimal care and outcomes for newborns with CDH.

SUBMITTER: Carmichael SL 

PROVIDER: S-EPMC7260105 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature