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Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study

Natalie Divin Orcid Logo, Joanne Emma Given Orcid Logo, Joachim Tan, Gianni Astolfi, Elisa Ballardini, Laia Barrachina-Bonet, Clara Cavero-Carbonell Orcid Logo, Alessio Coi, Ester Garne Orcid Logo, Mika Gissler, Anna Heino, Sue Jordan Orcid Logo, Anna Pierini, Ieuan Scanlon, Stine Kjær Urhøj, Joan K Morris Orcid Logo, Maria Loane Orcid Logo

BMJ Open, Volume: 13, Issue: 10, Start page: e068885

Swansea University Authors: Sue Jordan Orcid Logo, Ieuan Scanlon

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Abstract

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 we...

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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: BMJ 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa64752
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Abstract: 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.
Keywords: Antiasthmatic prescriptions, congenital anomalies, children, respiratory symptoms, EUROlinkCAT
College: Faculty of Medicine, Health and Life Sciences
Funders: This work was supported by the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 733001.
Issue: 10
Start Page: e068885