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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 (