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Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study

Joachim Tan Orcid Logo, Svetlana V. Glinianaia Orcid Logo, Judith Rankin Orcid Logo, Anna Pierini, Michele Santoro, Alessio Coi, Ester Garne, Maria Loane, Joanne E. Given Orcid Logo, Joanna Brigden, Elisa Ballardini, Clara Cavero‐Carbonell, Hermien E. K. de Walle, Laura García‐Villodre, Miriam Gatt, Mika Gissler, Anna Heino, Sue Jordan Orcid Logo, Babak Khoshnood Orcid Logo, Kari Klungsoyr, Nathalie Lelong, Renée L. Lutke, Amanda J. Neville, David Tucker, Stine K. Urhoj, Diana Wellesley, Joan K. Morris Orcid Logo

Paediatric and Perinatal Epidemiology

Swansea University Author: Sue Jordan Orcid Logo

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DOI (Published version): 10.1111/ppe.13010

Abstract

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. O...

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Published in: Paediatric and Perinatal Epidemiology
ISSN: 0269-5022 1365-3016
Published: Wiley 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa64753
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>64753</id><entry>2023-10-16</entry><title>Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study</title><swanseaauthors><author><sid>24ce9db29b4bde1af4e83b388aae0ea1</sid><ORCID>0000-0002-5691-2987</ORCID><firstname>Sue</firstname><surname>Jordan</surname><name>Sue Jordan</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-10-16</date><deptcode>HNU</deptcode><abstract>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 &lt;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 &lt;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 &lt;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 &lt;20 years (versus 20–34 years) was a risk factor for death &lt;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.</abstract><type>Journal Article</type><journal>Paediatric and Perinatal Epidemiology</journal><volume/><journalNumber/><paginationStart/><paginationEnd/><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0269-5022</issnPrint><issnElectronic>1365-3016</issnElectronic><keywords>Congenital anomalies, gestational age, maternal age, mortality, risk factors</keywords><publishedDay>23</publishedDay><publishedMonth>11</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-11-23</publishedDate><doi>10.1111/ppe.13010</doi><url>http://dx.doi.org/10.1111/ppe.13010</url><notes/><college>COLLEGE NANME</college><department>Nursing</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HNU</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>Horizon 2020 Framework Programme</funders><projectreference/><lastEdited>2023-11-23T13:53:19.0844646</lastEdited><Created>2023-10-16T13:12:52.8928514</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Nursing</level></path><authors><author><firstname>Joachim</firstname><surname>Tan</surname><orcid>0000-0003-0462-4761</orcid><order>1</order></author><author><firstname>Svetlana V.</firstname><surname>Glinianaia</surname><orcid>0000-0001-6690-4975</orcid><order>2</order></author><author><firstname>Judith</firstname><surname>Rankin</surname><orcid>0000-0001-5355-454x</orcid><order>3</order></author><author><firstname>Anna</firstname><surname>Pierini</surname><order>4</order></author><author><firstname>Michele</firstname><surname>Santoro</surname><order>5</order></author><author><firstname>Alessio</firstname><surname>Coi</surname><order>6</order></author><author><firstname>Ester</firstname><surname>Garne</surname><order>7</order></author><author><firstname>Maria</firstname><surname>Loane</surname><order>8</order></author><author><firstname>Joanne E.</firstname><surname>Given</surname><orcid>0000-0003-4921-1944</orcid><order>9</order></author><author><firstname>Joanna</firstname><surname>Brigden</surname><order>10</order></author><author><firstname>Elisa</firstname><surname>Ballardini</surname><order>11</order></author><author><firstname>Clara</firstname><surname>Cavero‐Carbonell</surname><order>12</order></author><author><firstname>Hermien E. K. de</firstname><surname>Walle</surname><order>13</order></author><author><firstname>Laura</firstname><surname>García‐Villodre</surname><order>14</order></author><author><firstname>Miriam</firstname><surname>Gatt</surname><order>15</order></author><author><firstname>Mika</firstname><surname>Gissler</surname><order>16</order></author><author><firstname>Anna</firstname><surname>Heino</surname><order>17</order></author><author><firstname>Sue</firstname><surname>Jordan</surname><orcid>0000-0002-5691-2987</orcid><order>18</order></author><author><firstname>Babak</firstname><surname>Khoshnood</surname><orcid>0000-0002-4031-4915</orcid><order>19</order></author><author><firstname>Kari</firstname><surname>Klungsoyr</surname><order>20</order></author><author><firstname>Nathalie</firstname><surname>Lelong</surname><order>21</order></author><author><firstname>Renée L.</firstname><surname>Lutke</surname><order>22</order></author><author><firstname>Amanda J.</firstname><surname>Neville</surname><order>23</order></author><author><firstname>David</firstname><surname>Tucker</surname><order>24</order></author><author><firstname>Stine K.</firstname><surname>Urhoj</surname><order>25</order></author><author><firstname>Diana</firstname><surname>Wellesley</surname><order>26</order></author><author><firstname>Joan K.</firstname><surname>Morris</surname><orcid>0000-0002-7164-612x</orcid><order>27</order></author></authors><documents><document><filename>64753__29095__37022e0145624691973658a2b8c3bd0e.pdf</filename><originalFilename>64753.VOR.pdf</originalFilename><uploaded>2023-11-23T13:50:33.2719573</uploaded><type>Output</type><contentLength>427504</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2023 The Authors. 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spelling v2 64753 2023-10-16 Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study 24ce9db29b4bde1af4e83b388aae0ea1 0000-0002-5691-2987 Sue Jordan Sue Jordan true false 2023-10-16 HNU 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. Journal Article Paediatric and Perinatal Epidemiology Wiley 0269-5022 1365-3016 Congenital anomalies, gestational age, maternal age, mortality, risk factors 23 11 2023 2023-11-23 10.1111/ppe.13010 http://dx.doi.org/10.1111/ppe.13010 COLLEGE NANME Nursing COLLEGE CODE HNU Swansea University Another institution paid the OA fee Horizon 2020 Framework Programme 2023-11-23T13:53:19.0844646 2023-10-16T13:12:52.8928514 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Joachim Tan 0000-0003-0462-4761 1 Svetlana V. Glinianaia 0000-0001-6690-4975 2 Judith Rankin 0000-0001-5355-454x 3 Anna Pierini 4 Michele Santoro 5 Alessio Coi 6 Ester Garne 7 Maria Loane 8 Joanne E. Given 0000-0003-4921-1944 9 Joanna Brigden 10 Elisa Ballardini 11 Clara Cavero‐Carbonell 12 Hermien E. K. de Walle 13 Laura García‐Villodre 14 Miriam Gatt 15 Mika Gissler 16 Anna Heino 17 Sue Jordan 0000-0002-5691-2987 18 Babak Khoshnood 0000-0002-4031-4915 19 Kari Klungsoyr 20 Nathalie Lelong 21 Renée L. Lutke 22 Amanda J. Neville 23 David Tucker 24 Stine K. Urhoj 25 Diana Wellesley 26 Joan K. Morris 0000-0002-7164-612x 27 64753__29095__37022e0145624691973658a2b8c3bd0e.pdf 64753.VOR.pdf 2023-11-23T13:50:33.2719573 Output 427504 application/pdf Version of Record true © 2023 The Authors. Paediatric and Perinatal Epidemiology published by John Wiley & Sons Ltd. Distributed under the terms of a Creative Commons Attribution 4.0 International License (CC BY 4.0). true eng https://creativecommons.org/licenses/by/4.0/
title Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study
spellingShingle Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study
Sue Jordan
title_short Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study
title_full Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study
title_fullStr Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study
title_full_unstemmed Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study
title_sort Risk factors for mortality in infancy and childhood in children with major congenital anomalies: A European population‐based cohort study
author_id_str_mv 24ce9db29b4bde1af4e83b388aae0ea1
author_id_fullname_str_mv 24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
author Sue Jordan
author2 Joachim Tan
Svetlana V. Glinianaia
Judith Rankin
Anna Pierini
Michele Santoro
Alessio Coi
Ester Garne
Maria Loane
Joanne E. Given
Joanna Brigden
Elisa Ballardini
Clara Cavero‐Carbonell
Hermien E. K. de Walle
Laura García‐Villodre
Miriam Gatt
Mika Gissler
Anna Heino
Sue Jordan
Babak Khoshnood
Kari Klungsoyr
Nathalie Lelong
Renée L. Lutke
Amanda J. Neville
David Tucker
Stine K. Urhoj
Diana Wellesley
Joan K. Morris
format Journal article
container_title Paediatric and Perinatal Epidemiology
publishDate 2023
institution Swansea University
issn 0269-5022
1365-3016
doi_str_mv 10.1111/ppe.13010
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
url http://dx.doi.org/10.1111/ppe.13010
document_store_str 1
active_str 0
description 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.
published_date 2023-11-23T13:53:20Z
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