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The increasing incidence of foetal echogenic congenital lung malformations: an observational study
Linden J Stocker1, Diana G Wellesley, Michael P Stanton
1University of Southampton, Faculty of Medicine, Academic Unit of Human Development and Health, UK.
Insights
The incidence of congenital lung malformations (CLM) detected before birth has more than tripled in the Wessex region over 19 years. This rise appears genuine, not due to improved detection methods.
Area of Science:
- Medical research
- Pediatric medicine
- Obstetrics
Background:
- Congenital lung malformations (CLM) are diverse abnormalities affecting fetal lung development.
- Antenatal diagnosis of CLM is crucial for planning fetal and neonatal management.
- Previous studies have not assessed the constancy of reported CLM incidence over time.
Purpose of the Study:
- To investigate the incidence trends of congenital lung malformations over a 19-year period.
- To determine if the reported incidence of CLM has remained constant.
- To evaluate the implications of CLM incidence changes for healthcare services.
Main Methods:
- Retrospective cross-sectional study design.
- Data sourced from the Wessex Antenatally Detected Anomalies (WANDA) register.
- Analysis of cases identified between 1994 and 2012.
Main Results:
- 133 cases of CLM identified among 524,372 live and stillbirths.
- Antenatal ultrasound detected all but seven cases.
- CLM incidence rose from 1.27 per 10,000 births (1994-1998) to 4.15 per 10,000 births (2008-2012).
Conclusions:
- A significant, threefold increase in antenatally detected CLM occurred in the Wessex region (1994-2012).
- The rise is likely a true increase in incidence, not solely due to improved antenatal detection technology or expertise.
- Findings have implications for fetal medicine, neonatology, and pediatric surgery resource planning.
Objectives:
The aim of this study was to investigate the incidence of congenital lung malformations over the past 19 years. Congenital lung malformations (CLM) are a heterogeneous group of lung abnormalities. The antenatal diagnosis is important for foetal and neonatal management but there have been no studies examining whether the reported incidence of this abnormality is constant.
Methods:
A retrospective cross-sectional study of cases identified from the Wessex Antenatally Detected Anomalies (WANDA) register 1994-2012.
Results:
One hundred and thirty-three cases of CLM in 524 372 live and stillbirths were identified. All but seven were identified on antenatal ultrasound. During the early registry (1994-1998) the average incidence of CLM was 1.27 per 10,000 births. By the last 4 years (2008-2012) this had risen to 4.15 per 10,000 births, with a progressive increase during the intervening years.
Conclusion:
There was over a three-fold increase in the antenatally detected CLM in the Wessex region 1994-2012. Comparison with the antenatal detection of diaphragmatic hernia suggests that this is a true rise in incidence rather than an artefactual increase due to increased antenatal recognition secondary to improved ultrasound resolution and operator experience. These results have clinical and cost implications for practitioners of foetal medicine, neonatology and paediatric surgery services.
