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Birth prevalence of anorectal malformations in England and 5-year survival: a national birth cohort study

Kathryn Ford1,2, Maria Peppa2, Ania Zylbersztejn2

  • 1Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, London, UK kathryneford@gmail.com.

Archives of Disease in Childhood
|March 23, 2022
PubMed

Insights

Anorectal malformations affect 3.5 per 10,000 births. Complex cases are linked to maternal age extremes, with lower survival rates, especially in preterm infants.

Area of Science:

  • Pediatric Surgery
  • Congenital Anomalies
  • Epidemiology

Background:

  • Anorectal malformations (ARMs) are congenital anomalies with varying prevalence and outcomes.
  • Understanding risk factors and survival rates is crucial for clinical management and public health.
  • Previous studies have often focused on specific subtypes or limited geographic regions.

Purpose of the Study:

  • To determine the birth prevalence of isolated and complex anorectal malformations.
  • To identify maternal risk factors associated with these conditions.
  • To assess the 5-year survival rates for infants with anorectal malformations.

Main Methods:

  • A national birth cohort study was conducted using hospital admission data and death records in England.
  • Live-born singletons diagnosed with anorectal malformations between 2002 and 2018 were included.
  • Cases were classified as isolated or complex based on the presence of additional anomalies.

Main Results:

  • A total of 3325 infants with anorectal malformations were identified, with a birth prevalence of 3.5 per 10,000 live births.
  • Complex anorectal malformations were more common (61.7%) and associated with maternal age extremes (≥35 or ≤24 years).
  • Five-year survival was 98.2% for isolated ARMs and 86.9% for complex ARMs, with preterm infants with complex ARMs having the lowest survival (73.4%).

Conclusions:

  • Maternal age extremes are significant risk factors for complex anorectal malformations, suggesting different underlying etiologies.
  • While overall 5-year survival for anorectal malformations is high, complex cases, particularly in preterm infants, face poorer prognoses.
  • These findings highlight the need for targeted interventions and further research into the mechanisms of anorectal malformations.
Abstract

Keywords:
Child HealthEpidemiologyMortalityPaediatrics

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