Gastrostomy and congenital anomalies - a European population-based study

Garne Ester, Joachim Tan, Maria Loane, Silvia Baldacci,, Elisa Ballardini,, Joanna Brigden, Clara Caverao-carbonell, Laura García-Villodre, Mika Gissler, Joanne Given, Anna Heino, Sue Jordan, Elizabeth Limb, Amanda Neville, Anke Rissmann, Michele Santoro, Ieuan Scanlon, Stine Urhøj, Diana Wellesley, Joan K Morris

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Objective: To report and compare the proportion of children with and without congenital anomalies undergoing gastrostomy for tube feeding in their first 5 years. Methods: A European, population-based data-linkage cohort study (EUROlinkCAT). Children up to 5 years of age registered in nine EUROCAT registries (national and regional) in six countries and children without congenital anomalies (reference children) living in the same geographical areas were included. Data on hospitalisation and surgical procedures for all children were obtained by electronic linkage to hospital databases. Results: The study included 91 504 EUROCAT children and 1 960 272 reference children. Overall, 1200 (1.3%, 95% CI 1.2% to 1.6%) EUROCAT children and 374 (0.016%, 95% CI 0.009% to 0.026%) reference children had a surgical code for gastrostomy within the first 5 years of life. There were geographical variations across Europe with higher rates in Northern Europe compared with Southern Europe. Around one in four children with Cornelia de Lange syndrome and Wolf-Hirschhorn syndrome had a gastrostomy. Among children with structural anomalies, those with oesophageal atresia had the highest proportion of gastrostomy (15.9%). Conclusions: This study including almost 2 million reference children in Europe found that only 0.016% of these children had a surgery code for gastrostomy before age 5 years. The children with congenital anomalies were on average 80 times more likely to need a gastrostomy before age 5 years than children without congenital anomalies. More than two-thirds of gastrostomy procedures performed within the first 5 years of life were in children with congenital anomalies.
Original languageEnglish
Article numbere001526
Pages (from-to)1-5
Number of pages5
JournalBMJ Paediatrics Open
Issue number1
Publication statusPublished (in print/issue) - 24 Jun 2022

Bibliographical note

Funding Information:
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 733001.

Publisher Copyright:


  • Original research
  • 1506
  • epidemiology
  • Gastrostomy
  • Esophageal Atresia
  • Humans
  • Registries
  • Cohort Studies
  • Databases, Factual


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