Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population-based cohort study
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Risk factors for mortality in infancy and childhood in children with major congenital anomalies : A European population-based cohort study. / Tan, Joachim; Glinianaia, Svetlana V; Rankin, Judith; Pierini, Anna; Santoro, Michele; Coi, Alessio; Garne, Ester; Loane, Maria; Given, Joanne E; Brigden, Joanna; Ballardini, Elisa; Cavero-Carbonell, Clara; de Walle, Hermien E K; García-Villodre, Laura; Gatt, Miriam; Gissler, Mika; Heino, Anna; Jordan, Sue; Khoshnood, Babak; Klungsoyr, Kari; Lelong, Nathalie; Lutke, Renée L; Neville, Amanda J; Tucker, David; Urhoj, Stine K; Wellesley, Diana; Morris, Joan K.
I: Paediatric and Perinatal Epidemiology, Bind 37, Nr. 8, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Risk factors for mortality in infancy and childhood in children with major congenital anomalies
T2 - A European population-based cohort study
AU - Tan, Joachim
AU - Glinianaia, Svetlana V
AU - Rankin, Judith
AU - Pierini, Anna
AU - Santoro, Michele
AU - Coi, Alessio
AU - Garne, Ester
AU - Loane, Maria
AU - Given, Joanne E
AU - Brigden, Joanna
AU - Ballardini, Elisa
AU - Cavero-Carbonell, Clara
AU - de Walle, Hermien E K
AU - García-Villodre, Laura
AU - Gatt, Miriam
AU - Gissler, Mika
AU - Heino, Anna
AU - Jordan, Sue
AU - Khoshnood, Babak
AU - Klungsoyr, Kari
AU - Lelong, Nathalie
AU - Lutke, Renée L
AU - Neville, Amanda J
AU - Tucker, David
AU - Urhoj, Stine K
AU - Wellesley, Diana
AU - Morris, Joan K
N1 - © 2023 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Preterm birth and young maternal age are known risk factors for infant and childhood mortality. There is limited knowledge of the impact of these risk factors in children born with major congenital anomalies (CAs), who have inherently higher risks of death compared with other children.OBJECTIVES: To investigate the risk factors for mortality up to age 10 years in children born with specific major CAs.METHODS: This population-based cohort study involved 150,198 livebirths from 1995 to 2014 in 13 European CA registries linked to mortality data. Cox proportional hazards models estimated the association of gestational age, maternal age and child's sex with death <1 year and 1-9 years for the whole cohort and by CA subgroup. Hazard ratios (HR) from each registry were pooled using multivariate meta-analysis.RESULTS: Preterm birth had a dose-response association with mortality; compared with infants born at 37+ weeks gestation, those born at <28, 28-31 and 32-36 weeks had 14.88 (95% CI 12.57, 17.62), 8.39 (95% CI 7.16, 9.85) and 3.88 (95% CI 3.40, 4.43) times higher risk of death <1 year, respectively. The corresponding risks at 1-9 years were 4.99 (95% CI 2.94, 8.48), 3.09 (95% CI 2.28, 4.18) and 2.04 (95% CI 1.69, 2.46) times higher, respectively. Maternal age <20 years (versus 20-34 years) was a risk factor for death <1 year (HR 1.30, 95% CI 1.09, 1.54) and 1-9 years (HR 1.58, 95% CI 1.19, 2.10). Females had 1.22 (95% CI: 1.07, 1.39) times higher risk of death between 1 and 9 years than males.CONCLUSION: Preterm birth was associated with considerably higher infant and childhood mortality in children with CAs, comparable to estimates reported elsewhere for the background population. Additional risk factors included young maternal age and female sex. Information on risk factors could benefit clinical care and guide counselling of parents following CA diagnoses.
AB - BACKGROUND: Preterm birth and young maternal age are known risk factors for infant and childhood mortality. There is limited knowledge of the impact of these risk factors in children born with major congenital anomalies (CAs), who have inherently higher risks of death compared with other children.OBJECTIVES: To investigate the risk factors for mortality up to age 10 years in children born with specific major CAs.METHODS: This population-based cohort study involved 150,198 livebirths from 1995 to 2014 in 13 European CA registries linked to mortality data. Cox proportional hazards models estimated the association of gestational age, maternal age and child's sex with death <1 year and 1-9 years for the whole cohort and by CA subgroup. Hazard ratios (HR) from each registry were pooled using multivariate meta-analysis.RESULTS: Preterm birth had a dose-response association with mortality; compared with infants born at 37+ weeks gestation, those born at <28, 28-31 and 32-36 weeks had 14.88 (95% CI 12.57, 17.62), 8.39 (95% CI 7.16, 9.85) and 3.88 (95% CI 3.40, 4.43) times higher risk of death <1 year, respectively. The corresponding risks at 1-9 years were 4.99 (95% CI 2.94, 8.48), 3.09 (95% CI 2.28, 4.18) and 2.04 (95% CI 1.69, 2.46) times higher, respectively. Maternal age <20 years (versus 20-34 years) was a risk factor for death <1 year (HR 1.30, 95% CI 1.09, 1.54) and 1-9 years (HR 1.58, 95% CI 1.19, 2.10). Females had 1.22 (95% CI: 1.07, 1.39) times higher risk of death between 1 and 9 years than males.CONCLUSION: Preterm birth was associated with considerably higher infant and childhood mortality in children with CAs, comparable to estimates reported elsewhere for the background population. Additional risk factors included young maternal age and female sex. Information on risk factors could benefit clinical care and guide counselling of parents following CA diagnoses.
U2 - 10.1111/ppe.13010
DO - 10.1111/ppe.13010
M3 - Journal article
C2 - 37817457
VL - 37
JO - Paediatric and Perinatal Epidemiology
JF - Paediatric and Perinatal Epidemiology
SN - 0269-5022
IS - 8
ER -
ID: 369782675