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Infant Mortality due to Congenital Diaphragmatic Hernia, United States 2007-2021

Ramesh Vidavalur1,2, Kanekal S Gautham3

  • 1Division of Neonatology, Cayuga Medical Center, Ithaca, New York, USA.

Birth Defects Research
|November 12, 2025
PubMed

Insights

Infant mortality from congenital diaphragmatic hernia (CDH) is decreasing nationally, but significant geographic and demographic disparities persist. Further efforts are needed to ensure equitable outcomes for all infants with CDH.

Area of Science:

  • Pediatric Health
  • Public Health Surveillance
  • Neonatal Outcomes

Background:

  • Congenital diaphragmatic hernia (CDH) is a serious birth defect impacting infant survival.
  • Understanding temporal and geographic trends in CDH-related infant mortality is crucial for public health interventions.

Purpose of the Study:

  • To analyze temporal trends and geographic variations in the infant mortality rate associated with congenital diaphragmatic hernia (CDH-IMR) in the United States.
  • To identify demographic factors influencing CDH-IMR and explore regional disparities.

Main Methods:

  • Utilized CDC-WONDER linked birth/death data from 2007-2021 to identify CDH-related infant deaths (ICD-10: Q79).
  • Analyzed annual CDH-IMR trends using joinpoint regression and explored associations with sex, gender, gestational age (GA), and U.S. state of birth.
  • Calculated CDH-IMR per 100,000 live births and conducted bivariate analyses for demographic and regional comparisons.

Main Results:

  • A total of 3391 CDH-related infant deaths were recorded among over 59 million live births between 2007 and 2021.
  • The overall CDH-IMR showed a significant downward trend (APC: -1.3%).
  • Significant variations in CDH-IMR were observed across U.S. states (three-fold range), with lower mortality risk noted in Asian infants and improved survival associated with higher GA.

Conclusions:

  • A decreasing trend in congenital diaphragmatic hernia infant mortality rate (CDH-IMR) was observed in the U.S.
  • Despite the overall decline, significant disparities in CDH mortality persist based on region, gender, and race.
  • Equitable improvements in care are needed to address variations in outcomes across different demographic groups and geographic locations.
Abstract

Keywords:
United Statescongenital diaphragmatic herniainfant mortalityjoinpoint regressiontrends

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