Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort study

Objective To evaluate risk factors for hospital admission and length of stay (LOS) among children with and without congenital anomalies (CAs).Design A population-based linkage cohort study including 50 353 children with major CAs and 1 259 925 children without CAs from four EUROCAT registry areas in...

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Main Authors: Mika Gissler, Maria Loane, Joan K Morris, Ester Garne, Silvia Baldacci, Francesca Gorini, Elisa Ballardini, Marco Manfrini, Joachim Tan, Stine Kjaer Urhoj, Sonja Kiuru-Kuhlefelt, Joanne Given
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/9/1/e003586.full
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author Mika Gissler
Maria Loane
Joan K Morris
Ester Garne
Silvia Baldacci
Francesca Gorini
Elisa Ballardini
Marco Manfrini
Joachim Tan
Stine Kjaer Urhoj
Sonja Kiuru-Kuhlefelt
Joanne Given
author_facet Mika Gissler
Maria Loane
Joan K Morris
Ester Garne
Silvia Baldacci
Francesca Gorini
Elisa Ballardini
Marco Manfrini
Joachim Tan
Stine Kjaer Urhoj
Sonja Kiuru-Kuhlefelt
Joanne Given
author_sort Mika Gissler
collection DOAJ
description Objective To evaluate risk factors for hospital admission and length of stay (LOS) among children with and without congenital anomalies (CAs).Design A population-based linkage cohort study including 50 353 children with major CAs and 1 259 925 children without CAs from four EUROCAT registry areas in three countries. Data on children born 1995–2014 were linked to hospital discharge databases 1995–2015. HRs and incidence rate ratios estimated risk of admission and LOS for children aged <1 and 1–4 years by birth cohort, gestational age, sex, maternal age, multiple births and maternal education. Estimates were pooled using random effects meta-analysis.Results In children <1 year, twins/triplets with CAs were 34% more likely to be admitted and had over two times the LOS compared with singletons, while twins/triplets without CAs were over two and a half times as likely to be admitted and had six times longer stays. Despite this, a higher proportion of twins/triplets with CAs were admitted compared to those without CAs (91% vs 65%) and had longer LOS (20 days vs 10). Smaller increases in risk of admission or LOS were found in boys, young mothers and low maternal education. Preterm birth was a major risk factor for admission and LOS.Conclusions While the impact of risk factors on hospital admission and LOS was generally greater in children without CAs, a higher proportion of children with CAs were admitted and had longer stays. These findings have implications for health care planning and for counselling parents regarding their child's future healthcare needs.
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spelling doaj-art-562d5a277e4e4909b25b5dbc59fbadcb2025-08-20T03:04:49ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-08-019110.1136/bmjpo-2025-003586Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort studyMika Gissler0Maria Loane1Joan K Morris2Ester Garne3Silvia Baldacci4Francesca Gorini5Elisa Ballardini6Marco Manfrini7Joachim Tan8Stine Kjaer Urhoj9Sonja Kiuru-Kuhlefelt10Joanne Given1112 Academic Primary Health Care Centre, Region Stockholm, Stockholm, Sweden6 Institute of Nursing and Health Research, Ulster University, Belfast, UK19 School of Health and Medical Sciences, St George’s University, London, UK5 Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, Kolding, Denmark3 Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, ItalyIstituto Auxologico Italiano IRCCS, Milan, Italy8 Neonatal Intensive Care Unit, Paediatric Section, IMER Registry (Emilia Romagna Registry of Birth Defects), Department of Medical Sciences, University of Ferrara, Ferrara, ItalyFrom the *Unit of Anaesthesia and Pain Therapy and †Orthopaedic Clinic, Rizzoli Orthopaedic Institute; and ‡Department of Anesthesiology, University of Bologna, Bologna, Italy4 NIHR GOSH BRC, London, UKDepartment of Public Health, University of Copenhagen, Copenhagen, DenmarkKnowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland2 Centre for Maternal, Fetal and Infant Research, INHR, Ulster University, Belfast, Northern Ireland, UKObjective To evaluate risk factors for hospital admission and length of stay (LOS) among children with and without congenital anomalies (CAs).Design A population-based linkage cohort study including 50 353 children with major CAs and 1 259 925 children without CAs from four EUROCAT registry areas in three countries. Data on children born 1995–2014 were linked to hospital discharge databases 1995–2015. HRs and incidence rate ratios estimated risk of admission and LOS for children aged <1 and 1–4 years by birth cohort, gestational age, sex, maternal age, multiple births and maternal education. Estimates were pooled using random effects meta-analysis.Results In children <1 year, twins/triplets with CAs were 34% more likely to be admitted and had over two times the LOS compared with singletons, while twins/triplets without CAs were over two and a half times as likely to be admitted and had six times longer stays. Despite this, a higher proportion of twins/triplets with CAs were admitted compared to those without CAs (91% vs 65%) and had longer LOS (20 days vs 10). Smaller increases in risk of admission or LOS were found in boys, young mothers and low maternal education. Preterm birth was a major risk factor for admission and LOS.Conclusions While the impact of risk factors on hospital admission and LOS was generally greater in children without CAs, a higher proportion of children with CAs were admitted and had longer stays. These findings have implications for health care planning and for counselling parents regarding their child's future healthcare needs.https://bmjpaedsopen.bmj.com/content/9/1/e003586.full
spellingShingle Mika Gissler
Maria Loane
Joan K Morris
Ester Garne
Silvia Baldacci
Francesca Gorini
Elisa Ballardini
Marco Manfrini
Joachim Tan
Stine Kjaer Urhoj
Sonja Kiuru-Kuhlefelt
Joanne Given
Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort study
BMJ Paediatrics Open
title Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort study
title_full Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort study
title_fullStr Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort study
title_full_unstemmed Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort study
title_short Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort study
title_sort risk factors for hospital admission and length of stay for children with and without congenital anomalies a eurolinkcat cohort study
url https://bmjpaedsopen.bmj.com/content/9/1/e003586.full
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