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Eur J Pediatr Surg 2019; 29(03): 282-289
DOI: 10.1055/s-0038-1642630
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Epidemiology and Outcome of Major Congenital Malformations in a Large German County

Boris Wittekindt
1   Department of Neonatology, Universitätsklinikum Frankfurt, Frankfurt, Hesse, Germany
,
Rolf Schloesser
1   Department of Neonatology, Universitätsklinikum Frankfurt, Frankfurt, Hesse, Germany
,
Nora Doberschuetz
1   Department of Neonatology, Universitätsklinikum Frankfurt, Frankfurt, Hesse, Germany
,
Emilia Salzmann-Manrique
2   Department of Pediatric Stem Cell Transplantation, Universitätsklinikum Frankfurt, Frankfurt, Hesse, Germany
,
Jasmin Grossmann
3   Institute of Quality Assurance, Eschborn, Hesse, Germany
,
Bjoern Misselwitz
3   Institute of Quality Assurance, Eschborn, Hesse, Germany
,
Udo Rolle
4   Klinik für Kinderchirurgie, Klinikum der Johann Wolfgang-Goethe Universität Frankfurt, Frankfurt, Hesse, Germany
› Author Affiliations
Further Information

Publication History

27 September 2017

16 March 2018

Publication Date:
01 May 2018 (online)

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Abstract

Introduction Congenital malformations are associated with substantial neonatal morbidity and mortality. Furthermore, only sparse data are available on the modalities of care provided to and the associated clinical outcomes in affected neonates. In this study, we focused on five malformations that require surgery during the neonatal period: duodenal stenosis and atresia (DA), gastroschisis (GA), omphalocele (OM), congenital diaphragmatic herniation (CDH), and esophageal atresia (EA).

Materials and Methods We reviewed the Hessian neonatal registry (2010–2015) to identify records including the ICD-10 (International Classification of Diseases, Tenth Edition) codes for the aforementioned diagnoses and identified 283 patients who were affected by at least one of these conditions. Multiple regression analyses were performed to further identify risk factors for mortality and extended length of hospital stay.

Results The incidence rates per 10,000 live births and inhospital mortality rates were as follows: DA: 1.79 and 3.6%; GA: 1.79 and 1.8%; OM: 1.60 and 24%; CDH: 1.32 and 27.5%; and EA: 2.67 and 11.1%, respectively. Thirty-three percent of the patients had not been born in a perinatal center in which corrective surgeries were performed. The following risk factors were significantly associated with early mortality: trisomy 13 and 18, congenital heart defects, prematurity, and high-risk malformations (OM and CDH). The predictors of length of stay were as follows: gestational age, number of additional malformations, and treatment in the center with the highest patient volume.

Conclusion Epidemiology and outcome of major congenital malformations in Hesse, Germany, are comparable to previously published data. In addition, our data revealed a volume–outcome association with regard to the length of hospital stay.

Keywords

congenital malformation - neonate - esophageal atresia - outcome - caseload

Supplementary Material

 

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