Epidemiology and Prognostic Factors of Three Major Neonatal Congenital Malformations in France: A 10-Year PMSI-Based...

Congenital anomalies are a major cause of neonatal morbidity and mortality. In France, nationwide data describing surgical congenital malformations based on standardized hospital databases remain limited. To describe the epidemiology, management, and short-term outcomes of three major surgically relevant congenital malformations-gastroschisis (laparoschisis), omphalocele, and anorectal malformations-using the French national hospital discharge database from 2015 to 2024, and to identify prognostic factors for in-hospital mortality and length of stay. We conducted a retrospective PMSI-based study including neonates with the target malformations identified through ICD-10 and CCAM codes. Temporal trends, surgical management, and multivariable determinants of mortality and LOS were examined. National prevalence remained stable across the decade. In-hospital mortality was highest for omphalocele (7.9%), whereas ARMs showed lower mortality but substantial clinical heterogeneity linked to anatomical variability and associated anomalies. Major surgery was independently protective. Higher birthweight and greater gestational age were independently associated with lower in-hospital mortality. From 2015 to 2024, these malformations exhibited stable epidemiology but distinct prognostic profiles in France. Early individualized surgical management and perioperative strategies targeting prematurity and low birthweight may improve outcomes. Nationwide PMSI data support large-scale surveillance but require consideration of coding-related limitations.