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

Abstract

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.