Risk factors for hospitalisation in Welsh infants with a congenital anomaly
Peter S Y Ho1, Maria A Quigley2,3, David F Tucker4
1National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK Peterhosy@hotmail.com.
Insights
Younger maternal age, smoking, and preterm birth increase infant hospitalizations for congenital anomalies. Girls had a lower risk. Understanding these factors aids in managing care for affected infants.
Area of Science:
- Pediatrics
- Public Health
- Genetics
Background:
- Congenital anomalies affect a significant number of livebirths.
- Infants with congenital anomalies often require multiple hospital admissions during infancy.
- Identifying risk factors for hospitalization is crucial for resource allocation and care management.
Purpose of the Study:
- To investigate risk factors associated with infant hospitalization among those with congenital anomalies in Wales.
- To identify sociodemographic, maternal, and infant factors influencing the frequency of hospital admissions.
Main Methods:
- A population-based cohort study utilizing data from the Welsh Congenital Anomaly Register and linked databases.
- Inclusion of all livebirths between 1999 and 2015 diagnosed with congenital anomalies.
- Multinomial logistic regression was used to estimate adjusted odds ratios (aOR) for hospitalization risk.
Main Results:
- Over two-thirds of infants with congenital anomalies were hospitalized during infancy.
- Risk factors for multiple admissions included younger maternal age (≤24 years), maternal smoking, preterm birth, and severe congenital heart defects.
- Female infants had a decreased risk of multiple admissions.
Conclusions:
- Sociodemographic and clinical factors significantly contribute to the risk of hospitalisation in infants with congenital anomalies.
- Preterm birth was a consistent risk factor across all anomaly subgroups.
- Findings highlight key areas for intervention to reduce hospitalisation burden in this population.
Objectives:
To investigate risk factor associated with hospitalisation of infants with a congenital anomaly in Wales, UK.
Design:
A population-based cohort study.
Setting:
Data from the Welsh Congenital Anomaly Register and Information Service linked to the Patient Episode Database for Wales and livebirths and deaths from the Office for National Statistics.
Patients:
All livebirths between 1999 and 2015 with a diagnosis of a congenital anomaly, which was defined as a structural, metabolic, endocrine or genetic defect, as well as rare diseases of hereditary origin.
Main Outcome Measures:
Adjusted OR (aOR) associated with 1 or 2+ hospital admissions in infancy versus no admissions were estimated for sociodemographic, maternal and infant factors using multinomial logistic regression for the subgroups of all, isolated, multiple and cardiovascular anomalies.
Results:
25 523 infants affected by congenital anomalies experienced a total of 50 705 admissions in infancy. Risk factors for ≥2 admissions were younger maternal age ≤24 years (aOR: 1.17; 95% CI 1.06 to 1.30), maternal smoking (aOR: 1.20; 1.10 to 1.31), preterm birth (aOR: 2.52; 2.25 to 2.83) and moderately severe congenital heart defects (aOR: 6.25; 4.47 to 8.74). Girls had an overall decreased risk of 2+ admissions (aOR: 0.84; 0.78 to 0.91). Preterm birth was a significant risk factor for admissions in all anomaly subgroups but the effect of the other characteristics varied according to anomaly subgroup.
Conclusions:
Over two-thirds of infants with an anomaly are admitted to hospital during infancy. Our findings identified sociodemographic and clinical characteristics contributing to an increased risk of hospitalisation of infants with congenital anomalies.
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