Table 4.
Association of sociodemographic, clinical and hospital characteristics with: a) delivery at a hospital with I-II versus III-IV level of neonatal care, and b) transfer from the birth hospital to another hospital for repair, among 577 infants born with congenital diaphragmatic hernia, California, 2006–2011.
| Relative risk (95% CI) for delivery at a level I-II (versus level III-IV) hospitalI | Relative risk (95% CI) for transfer to another hospital before repair (versus no transfer)I | |||
|---|---|---|---|---|
| Characteristics: | Unadjusted | Adjusted | Unadjusted | Adjusted |
| Maternal race-ethnicity | ||||
| Non-Hispanic white | Reference | Reference | Reference | Reference |
| US-born Hispanic | 1.2 (0.8–1.8) | 1.1 (0.7–1.7) | 1.0 (0.8–1.1) | 1.0 (0.9–1.1) |
| Foreign-born Hispanic | 1.4 (1.0–2.0) | 1.2 (0.8–1.9) | 1.0 (0.9–1.2) | 1.0 (0.9–1.1) |
| Non-Hispanic black | 0.6 (0.2–1.7) | 0.5 (0.2–1.6) | 0.7 (0.5–1.2) | 0.9 (0.8–1.1) |
| Asian/Pacific Islander | 0.6 (0.2–1.5) | 0.6 (0.2–1.6) | 0.8 (0.5–1.1) | 1.0 (0.8–1.1) |
| Other | 0.8 (0.4–1.7) | 0.8 (0.4–1.8) | 0.7 (0.5–1.1) | 1.0 (0.8–1.1) |
| Maternal education | ||||
| Less than high school completion | 1.4 (1.0–2.0) | 1.3 (0.9–1.9) | 1.1 (0.9–1.3) | 1.0 (0.9–1.1) |
| Completed high school | Reference | Reference | Reference | Reference |
| Greater than high school | 1.0 (0.7–1.4) | 1.3 (0.9–2.0) | 1.0 (0.8–1.1) | 1.0 (0.9–1.1) |
| Census tract poverty | ||||
| Lowest quartile | 1.0 (0.7–1.4) | 1.1 (0.7–1.5) | 1.0 (0.8–1.1) | 1.0 (0.9–1.1) |
| Middle quartiles | Reference | Reference | Reference | Reference |
| Highest quartile | 1.2 (0.9–1.7) | 1.0 (0.7–1.4) | 1.1 (1.0–1.3) | 1.0 (0.9–1.1) |
| Payer | ||||
| Medi-Cal/Other government | 1.4 (1.1–1.9) | 1.2 (0.8–1.7) | 1.1 (1.0–1.3) | 1.0 (0.9–1.1) |
| Non-government | Reference | Reference | Reference | Reference |
| Maternal age (per year) | 0.98 (0.96–1.00) | 0.97 (0.95–1.00) | 0.99 (0.98–1.00) | 1.00 (0.99–1.00) |
| Parity (number of previous live births) | ||||
| 0 | Reference | Reference | Reference | Reference |
| 1 or more | 1.2 (0.9–1.5) | 1.2 (0.9–1.6) | 1.0 (0.9–1.1) | 1.0 (0.9–1.1) |
| Initiation of prenatal care | ||||
| 1st or 2nd trimester | Reference | Reference | Reference | Reference |
| 3rd trimester or none | 1.7 (0.9–3.2) | 1.9 (1.0–3.6) | 0.9 (0.6–1.5) | 1.0 (0.8–1.2) |
| Birthweight (gm): | ||||
| <2500 | 0.8 (0.6–1.2) | 0.9 (0.7–1.3) | 0.8 (0.7–1.0) | 1.0 (0.9–1.1) |
| 2500 or more | Reference | Reference | Reference | Reference |
| Presence of other major birth defects:* | ||||
| None | Reference | Reference | Reference | Reference |
| Congenital heart defects | 0.8 (0.4–1.4) | 0.8 (0.4–1.5) | 0.6 (0.5–0.9) | 0.9 (0.8–1.1) |
| Other | 0.7 (0.3–1.4) | 0.6 (0.3–1.4) | 0.7 (0.4–1.0) | 0.9 (0.8–1.1) |
| 5-Minute Apgar score: | ||||
| <7 | 0.8 (0.6–1.1) | 0.8 (0.6–1.1) | 0.8 (0.7–0.9) | 1.0 (0.9–1.0) |
| 7 or higher | Reference | Reference | Reference | Reference |
| Level of care of birth hospital: | ||||
| Level I or II | n.a. | n.a. | 1.9 (1.7–2.1) | 1.2 (1.1–1.4) |
| Level III or IV | Reference | Reference | ||
I.
The model for level of care included 146 infants delivered at a level I-II hospital and 431 infants delivered at a level III-IV hospital. The model for transfer included 357 infants who were transferred and 220 infants who were not transferred. Both models included all variables in the table unless noted otherwise.