Divin Natalie, Given Joanne Emma, Tan Joachim, Astolfi Gianni, Ballardini Elisa, Barrachina-Bonet Laia, Cavero-Carbonell Clara, Coi Alessio, Garne Ester, Gissler Mika, Heino Anna, Jordan Susan, Pierini Anna, Scanlon Ieuan, Urhøj Stine Kjær, Morris Joan K, Loane Maria
Institute of Nursing and Health Research, Faculty of Life and Health Sciences,Ulster University, Belfast, UK.
Population Health Research Institute, St George's University of London, London, UK.
BMJ Open. 2023 Oct 13;13(10):e068885. doi: 10.1136/bmjopen-2022-068885.
To explore the risk of being prescribed/dispensed medications for respiratory symptoms and breathing difficulties in children with and without congenital anomalies.
A EUROlinkCAT population-based data linkage cohort study. Data on children with and without congenital anomalies were linked to prescription databases to identify children who did/did not receive antiasthmatic prescriptions. Data were analysed by age, European region, class of antiasthmatic, anomaly, sex, gestational age and birth cohort.
Children born 2000-2014 in six regions within five European countries.
60 662 children with congenital anomalies and 1 722 912 reference children up to age 10 years.
Relative risks (RR) of >1 antiasthmatic prescription in a year, identified using Anatomical Therapeutic Chemical classification codes beginning with R03.
There were significant differences in the prescribing of antiasthmatics in the six regions. Children with congenital anomalies had a significantly higher risk of being prescribed antiasthmatics (RR 1.41, 95% CI 1.35 to 1.48) compared with reference children. The increased risk was consistent across all regions and all age groups. Children with congenital anomalies were more likely to be prescribed beta-2 agonists (RR 1.71, 95% CI 1.60 to 1.83) and inhaled corticosteroids (RR 1.74, 95% CI 1.61 to 1.87). Children with oesophageal atresia, genetic syndromes and chromosomal anomalies had over twice the risk of being prescribed antiasthmatics compared with reference children. Children with congenital anomalies born <32 weeks gestational age were over twice as likely to be prescribed antiasthmatics than those born at term (RR 2.20, 95% CI 2.10 to 2.30).
This study documents the additional burden of respiratory symptoms and breathing difficulties for children with congenital anomalies, particularly those born preterm, compared with children without congenital anomalies in the first 10 years of life. These findings are beneficial to clinicians and healthcare providers as they identify children with greater morbidity associated with respiratory symptoms, as indicated by antiasthmatic prescriptions.
探讨患有和未患有先天性异常的儿童因呼吸道症状和呼吸困难而被开具/配发药物的风险。
一项基于EUROlinkCAT人群的数据链接队列研究。将患有和未患有先天性异常的儿童的数据与处方数据库相链接，以确定接受/未接受抗哮喘处方的儿童。数据按年龄、欧洲地区、抗哮喘药物类别、异常情况、性别、胎龄和出生队列进行分析。
在欧洲五个国家的六个地区2000年至2014年出生的儿童。
60662名患有先天性异常的儿童和1722912名10岁以下的对照儿童。
使用以R03开头的解剖治疗化学分类代码确定的一年内开具>1份抗哮喘处方的相对风险（RR）。
六个地区在抗哮喘药物的处方方面存在显著差异。与对照儿童相比，患有先天性异常的儿童被开具抗哮喘药物的风险显著更高（RR 1.41，95%CI 1.35至1.48）。所有地区和所有年龄组的风险增加都是一致的。患有先天性异常的儿童更有可能被开具β-2激动剂（RR 1.71，95%CI 1.60至1.83）和吸入性糖皮质激素（RR 1.74，95%CI 1.61至1.87）。与对照儿童相比，患有食管闭锁、遗传综合征和染色体异常的儿童被开具抗哮喘药物的风险高出两倍多。胎龄<32周出生的患有先天性异常的儿童被开具抗哮喘药物的可能性是足月出生儿童的两倍多（RR 2.20，95%CI 2.10至2.30）。
本研究记录了患有先天性异常的儿童，尤其是早产儿童，在生命的前10年中与未患有先天性异常的儿童相比，呼吸道症状和呼吸困难的额外负担。这些发现对临床医生和医疗保健提供者有益，因为它们确定了抗哮喘处方所表明的与呼吸道症状相关发病率更高的儿童。
