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Published on: April 17, 2020
Gastrostomy and congenital anomalies: a European population-based study
Ester Garne1, Joachim Tan2, Maria Loane3
1Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital-University Hospital of Southern Denmark, Kolding, Denmark egarne@dadlnet.dk.
Insights
Children with congenital anomalies are 80 times more likely to need gastrostomy tube feeding than healthy children. This study highlights the significant impact of congenital anomalies on the need for gastrostomy procedures in early childhood.
Area of Science:
- Pediatric surgery
- Congenital anomalies research
- Public health surveillance
Background:
- Gastrostomy tube feeding is a crucial intervention for children unable to obtain adequate nutrition orally.
- Congenital anomalies significantly impact a child's health and may necessitate specialized feeding support.
Purpose of the Study:
- To compare the incidence of gastrostomy procedures in children with and without congenital anomalies within their first five years of life.
- To identify specific congenital anomalies associated with a higher likelihood of requiring gastrostomy.
Main Methods:
- A European population-based data-linkage cohort study (EUROlinkCAT) was conducted.
- Included were children up to 5 years old registered in nine EUROCAT registries and a reference group of children without congenital anomalies.
- Data on hospitalizations and surgical procedures were obtained via electronic linkage to hospital databases.
Main Results:
- 1.3% of children with congenital anomalies and 0.016% of reference children underwent gastrostomy within the first 5 years.
- Children with congenital anomalies were 80 times more likely to require gastrostomy than reference children.
- Specific conditions like Cornelia de Lange syndrome, Wolf-Hirschhorn syndrome, and oesophageal atresia showed high gastrostomy rates.
Conclusions:
- Congenital anomalies are a major driver for gastrostomy procedures in young children.
- Over two-thirds of gastrostomies in the first five years were performed on children with congenital anomalies.
- Geographical variations in gastrostomy rates were observed across Europe.
Objective:
To report and compare the proportion of children with and without congenital anomalies undergoing gastrostomy for tube feeding in their first 5 years.
Methods:
A European, population-based data-linkage cohort study (EUROlinkCAT). Children up to 5 years of age registered in nine EUROCAT registries (national and regional) in six countries and children without congenital anomalies (reference children) living in the same geographical areas were included. Data on hospitalisation and surgical procedures for all children were obtained by electronic linkage to hospital databases.
Results:
The study included 91 504 EUROCAT children and 1 960 272 reference children. Overall, 1200 (1.3%, 95% CI 1.2% to 1.6%) EUROCAT children and 374 (0.016%, 95% CI 0.009% to 0.026%) reference children had a surgical code for gastrostomy within the first 5 years of life. There were geographical variations across Europe with higher rates in Northern Europe compared with Southern Europe. Around one in four children with Cornelia de Lange syndrome and Wolf-Hirschhorn syndrome had a gastrostomy. Among children with structural anomalies, those with oesophageal atresia had the highest proportion of gastrostomy (15.9%).
Conclusions:
This study including almost 2 million reference children in Europe found that only 0.016% of these children had a surgery code for gastrostomy before age 5 years. The children with congenital anomalies were on average 80 times more likely to need a gastrostomy before age 5 years than children without congenital anomalies. More than two-thirds of gastrostomy procedures performed within the first 5 years of life were in children with congenital anomalies.
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