|Title||Survival of infants with congenital diaphragmatic hernia in California: impact of hospital, clinical, and sociodemographic factors.|
|Publication Type||Journal Article|
|Year of Publication||2020|
|Authors||Carmichael SL, Ma C, Lee HC, Shaw GM, Sylvester KG, Hintz SR|
|Date Published||2020 06|
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.
|Alternate Journal||J Perinatol|
|PubMed Central ID||PMC7260105|
|Grant List||R01 MD007796 / MD / NIMHD NIH HHS / United States|