European study showed that children with congenital anomalies often underwent multiple surgical procedures at different ages across Europe

Garne Ester, Maria Loane, Joachim Tan, Elisa Ballardini,, Joanna Brigden, Clara Cavero-Carbonell, Alessio Coi, Mads Damkjær, Laura Garcia-Villodre, Mika Gissler, Joanne Given, Anna Heino, Sue Jordan, Elizabeth Limb, Amanda Neville, Anke Rissmann, Michele Santoro, Ieuan Scanlon, Stine Kjær Urhøj, Diana WellesleyJoan Morris

Research output: Contribution to journalArticlepeer-review

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AIM: Children with congenital anomalies often require surgery but data on the burden of surgery for these children are limited.

METHODS: A population-based record-linkage study in Finland, Wales and regions of Denmark, England, Italy and Spain. A total of 91 504 children with congenital anomalies born in 1995-2014 were followed to their tenth birthday or the end of 2015. Electronic linkage to hospital databases provided data on inpatient surgical procedures and meta-analyses of surgical procedures were performed by age groups.

RESULTS: The percentage of children having surgery in the first year was 38% with some differences across regions and 14% also underwent surgery at age 1-4 years. Regional differences in age at the time of their first surgical procedure were observed for children with cleft palate, hydronephrosis, hypospadias, clubfoot and craniosynostosis. The children had a median of 2.0 (95% CI 1.98, 2.02) surgical procedures before age 5 years with children with oesophageal atresia having the highest median number of procedures (4.5; 95% CI 3.3, 5.8).

CONCLUSION: A third of children with congenital anomalies required surgery during infancy and often more than one procedure was needed before age 5 years. There was no European consensus on the preferred age for surgery for some anomalies.

Original languageEnglish
Pages (from-to)1304-1311
Number of pages8
JournalActa Paediatrica
Issue number6
Early online date23 Feb 2023
Publication statusPublished (in print/issue) - 1 Jun 2023

Bibliographical note

Funding Information:
This project was funded by the European Union's Horizon 2020 research and innovation programme (Grant agreement number 733001). The funders played no role in the study or paper.

Publisher Copyright:
© 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.


  • congenital anomaly
  • median age
  • paediatric surgery
  • population-based record-linkage


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