Document Type

Journal Article

Publisher

BMJ Publishing Grouup

School

School of Medical and Health Sciences

RAS ID

25613

Comments

Originally published as:

Bishop, C., Small, N., Mason, D., Corry, P., Wright, J., Parslow, R. C., ... & Sheridan, E. (2017). Improving case ascertainment of congenital anomalies: Findings from a prospective birth cohort with detailed primary care record linkage. BMJ Paediatrics Open. Advance online publication. doi:10.1136/bmjpo-2017-000171

Original article available here.

Abstract

Background Congenital anomalies (CAs) are a common cause of infant death and disability. We linked children from a large birth cohort to a routine primary care database to detect CA diagnoses from birth to age 5 years. There could be evidence of underreporting by CA registries as they estimate that only 2% of CA registrations occur after age 1 year.

Methods CA cases were identified by linking children from a prospective birth cohort to primary care records. CAs were classified according to the European Surveillance of CA guidelines. We calculated rates of CAs by using a bodily system group for children aged 0 to <5 >years, together with risk ratios (RRs) with 95% CIs for maternal risk factors.

Results Routinely collected primary care data increased the ascertainment of children with CAs from 432.9 per 10 000 live births under 1 year to 620.6 per 10 000 live births under 5 years. Consanguinity was a risk factor for Pakistani mothers (multivariable RR 1.87, 95% CI 1.46 to 2.83), and maternal age >34 years was a risk factor for mothers of other ethnicities (multivariable RR 2.19, 95% CI 1.36 to 3.54). Education was associated with a lower risk (multivariable RR 0.78, 95% CI 0.62 to 0.98).

Conclusion 98% of UK CA registrations relate to diagnoses made in the first year of life. Our data suggest that this leads to incomplete case ascertainment with a further 30% identified after age 1 year in our study. Risk factors for CAs identified up to age 1 year persist up to 5 years. National registries should consider using routine data linkage to provide more complete case ascertainment after infancy.

DOI

10.1136/bmjpo-2017-000171

Access Rights

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Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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