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Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study
Natalie Divin1, Joanne Emma Given1, Joachim Tan2
1Institute of Nursing and Health Research, Faculty of Life and Health Sciences,Ulster University, Belfast, UK.
Insights
Children with congenital anomalies face a higher risk of respiratory issues, leading to more antiasthmatic prescriptions. This increased burden is particularly notable in preterm infants and those with specific genetic conditions.
Area of Science:
- Pediatric respiratory medicine
- Clinical epidemiology
- Congenital anomaly research
Background:
- Congenital anomalies can impact respiratory health.
- Understanding medication prescribing patterns is crucial for managing pediatric respiratory conditions.
Purpose of the Study:
- To investigate the risk of antiasthmatic medication prescriptions in children with and without congenital anomalies.
- To identify specific congenital anomaly types and factors associated with increased respiratory medication use.
Main Methods:
- A population-based data linkage cohort study (EUROlinkCAT) involving over 1.7 million children.
- Linked prescription data to identify antiasthmatic prescriptions (ATC codes R03) in children up to age 10.
- Analyzed prescription rates based on congenital anomaly status, age, region, medication class, sex, and gestational age.
Main Results:
- Children with congenital anomalies had a 41% higher risk of antiasthmatic prescriptions compared to reference children.
- Increased risk was observed across all regions and age groups, with higher rates for beta-2 agonists and inhaled corticosteroids.
- Specific anomalies (oesophageal atresia, genetic/chromosomal syndromes) and preterm birth (<32 weeks gestation) significantly elevated prescription risks.
Conclusions:
- Children with congenital anomalies experience a greater burden of respiratory symptoms and breathing difficulties.
- Preterm infants with congenital anomalies are at a substantially higher risk for respiratory medication use.
- Findings aid clinicians in identifying high-risk children needing targeted respiratory support.
Objectives:
To explore the risk of being prescribed/dispensed medications for respiratory symptoms and breathing difficulties in children with and without congenital anomalies.
Design:
A EUROlinkCAT population-based data linkage cohort study. Data on children with and without congenital anomalies were linked to prescription databases to identify children who did/did not receive antiasthmatic prescriptions. Data were analysed by age, European region, class of antiasthmatic, anomaly, sex, gestational age and birth cohort.
Setting:
Children born 2000-2014 in six regions within five European countries.
Participants:
60 662 children with congenital anomalies and 1 722 912 reference children up to age 10 years.
Primary Outcome Measure:
Relative risks (RR) of >1 antiasthmatic prescription in a year, identified using Anatomical Therapeutic Chemical classification codes beginning with R03.
Results:
There were significant differences in the prescribing of antiasthmatics in the six regions. Children with congenital anomalies had a significantly higher risk of being prescribed antiasthmatics (RR 1.41, 95% CI 1.35 to 1.48) compared with reference children. The increased risk was consistent across all regions and all age groups. Children with congenital anomalies were more likely to be prescribed beta-2 agonists (RR 1.71, 95% CI 1.60 to 1.83) and inhaled corticosteroids (RR 1.74, 95% CI 1.61 to 1.87). Children with oesophageal atresia, genetic syndromes and chromosomal anomalies had over twice the risk of being prescribed antiasthmatics compared with reference children. Children with congenital anomalies born <32 weeks gestational age were over twice as likely to be prescribed antiasthmatics than those born at term (RR 2.20, 95% CI 2.10 to 2.30).
Conclusion:
This study documents the additional burden of respiratory symptoms and breathing difficulties for children with congenital anomalies, particularly those born preterm, compared with children without congenital anomalies in the first 10 years of life. These findings are beneficial to clinicians and healthcare providers as they identify children with greater morbidity associated with respiratory symptoms, as indicated by antiasthmatic prescriptions.
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