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 |
Journal | J Perinatol |
Volume | 40 |
Issue | 6 |
Pagination | 943-951 |
Date Published | 2020 06 |
ISSN | 1476-5543 |
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. |
DOI | 10.1038/s41372-020-0612-6 |
Alternate Journal | J Perinatol |
PubMed ID | 32086437 |
PubMed Central ID | PMC7260105 |
Grant List | R01 MD007796 / MD / NIMHD NIH HHS / United States |