{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:02:41Z","timestamp":1787500961523,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2025,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n To analyze temporal trends and geographic variations in infant mortality rate associated with congenital diaphragmatic hernia (CDH\u2010IMR) in the United States.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n From 2007 to 2021, we used CDC\u2010WONDER linked birth\/death data to identify CDH\u2010related infant deaths (ICD\u201010 code: Q79 as the underlying cause of death), analyze annual CDH\u2010IMR trends, and explore associations with sex, gender, gestational age (GA), and U.S. state of birth. Descriptive statistics were derived, and bivariate analyses were conducted to discern differences in CDH\u2010IMR by gender, race, and GA. CDH\u2010IMR was expressed per 100,000 live births with Poisson\u2010modeled 95% confidence intervals, and trends were assessed through joinpoint regression to extrapolate annual percent change (APC).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Between 2007 and 2021, 59,117,761 live births and 3391 CDH\u2010related infant deaths were recorded. CDH infant deaths accounted for 0.96% of all infant deaths and occurred in 0.006% of live births. The mean CDH\u2010IMR was 5.7 (95% CI: 5.5\u20135.9) per 100,000 live births, with a significant downward trend (APC: \u22121.3%, [95% CI: \u22122.0, \u22120.5,\n p<\/jats:italic>\n \u2009<\u20090.01]). Asian infants had a lower risk of mortality (RR 0.66 [95% CI: 0.55, 0.79]) compared to White infants, and higher GA at birth correlated with better survival. Regional analysis revealed a median CDH\u2010IMR (IQR) of 5.9 (4.7, 7.2), with a three\u2010fold variation across U.S. states.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In this national population\u2010based U.S. study, we observed a decreasing trend in CDH\u2010IMR. However, significant variation in CDH mortality persists by region, gender, and race. Despite evidence of current CDH care is associated with a decreasing trend in mortality, there remain many opportunities for equitable improvement in outcomes across race, gender and by geographic region.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/bdr2.2544","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T11:17:23Z","timestamp":1762946243000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Infant Mortality due to Congenital Diaphragmatic Hernia, United States 2007\u20132021"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1476-7619","authenticated-orcid":false,"given":"Ramesh","family":"Vidavalur","sequence":"first","affiliation":[{"name":"Division of Neonatology Cayuga Medical Center Ithaca New York USA"},{"name":"Weill Cornell Medicine New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanekal S.","family":"Gautham","sequence":"additional","affiliation":[{"name":"Nemours Children's Health System University of Central Florida College of Medicine Orlando Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2025.114545"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7441.702"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2009.194"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007\u20103282"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302098"},{"key":"e_1_2_8_7_1","unstructured":"Centers for Disease Control and Prevention andNational Center for Health Statistics. n.d.National Vital Statistics System. Linked Birth\/Infant Deaths on CDC WONDER Online Database.http:\/\/wonder.cdc.gov\/lbd\u2010current.html."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2019.07.002"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/jpsu.2003.50194"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372\u2010023\u201001789\u2010z"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2024.06.002"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005113"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1015"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.2399"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2019.07.004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.9407"},{"key":"e_1_2_8_17_1","volume-title":"Care of the Infant With Congenital Diaphragmatic Hernia, Goldsmith's Assisted Ventilation of the Neonate","author":"Lakshminrusimha S.","year":"2022"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313480306900110"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211794"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100035\u20101544949"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2024.01.042"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2020.11.007"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdr2.1357"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2023.113481"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.10800"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1159\/000444210"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs5.50135"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.12.025"}],"container-title":["Birth Defects Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bdr2.2544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T09:48:06Z","timestamp":1765878486000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/bdr2.2544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":27,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/bdr2.2544"],"URL":"https:\/\/doi.org\/10.1002\/bdr2.2544","archive":["Portico"],"relation":{},"ISSN":["2472-1727","2472-1727"],"issn-type":[{"value":"2472-1727","type":"print"},{"value":"2472-1727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-08-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2544"}}