J Perinatol. 2020 Feb 21. doi: 10.1038/s41372-020-0612-6. [Epub ahead of print] https://www.ncbi.nlm.nih.gov/pubmed/32086437
Survival of infants with congenital diaphragmatic hernia in California: impact of hospital, clinical, and sociodemographic factors.
Carmichael SL1,2, Ma C3, Lee HC3, Shaw GM3, Sylvester KG4, Hintz SR3.
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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.PMID: 32086437 DOI: 10.1038/s41372-020-0612-6
