Prescription of cardiovascular medication in children with congenital heart defects across six European Regions from 2000 to 2014: data from the EUROlinkCAT population-based cohort study

Mads Damkjaer, Stine Kjaer Urhoj, Joachim Tan, Gillian Briggs, Maria Loane, Joanne Emma Given, Laia Barrachina-Bonet, Clara Cavero-Carbonell, Alessio Coi, Amanda J Neville, Anna Heino, Sonja Kiuru-Kuhlefelt, Susan Jordan, Ieuan Scanlon, Anna Pierini, Aurora Puccini, Ester Garne, Joan K Morris

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Advances in surgical management strategies have substantially reduced fatality from congenital heart defects (CHD). Decreased infant mortality might be expected, consequentially to result in greater morbidity in older children due to complications later in childhood and adolescence. This study aims to evaluate the use of cardiovascular medication (CVM) as an indicator of disease burden in children born with CHD in the first 10 years of life.

Design: Population-based cohort study.

Setting: Six population-based registries from the European Surveillance of Congenital Anomalies (EUROCAT) network participated. Data from live born children with major congenital anomalies (CA) born from 2000 to 2014 were linked to prescription databases. Four groups of children were analysed: CA, CHD, severe CHD (sCHD) and ventricular septal defect (VSD) without sCHD. Live born children without CA were included as reference group.

Participants: We obtained data on 61 038 children born with a CA, including 19 678 with CHD, 3392 with sCHD, 12 728 children with VSD without sCHD, and 1 725 496 reference children.

Results: Children born with sCHD were the most likely to receive a CVM prescription (42.9%, 95% CI, 26.3 to 58.5) in the first year of life compared with 13.3% (6.7 to 22.0) of children with any CHD, 5.9% (3.7 to 8.7) of children with any CA and 0.1% (0.0 to 0.1) of reference children. Medication was less likely to be prescribed after the first year of life for sCHD; 18.8% (14.8 to 23.1) for children 1–4 years and 15.8% (12.0 to 20.1) 5–9 years. Children with sCHD were most likely to receive a diuretic (36.4%, 18.6 to 54.5), an antihypertensive (6.9%, 3.7 to 11.3) or a beta-blocker (5.5%, 2.9 to9.2).

Conclusion: Almost half of all children with sCHD were prescribed CVM in their first year of life. For all four groups of children with anomalies, the proportion of children with a CVM prescription decreased with age.
Original languageEnglish
Article number057400
Pages (from-to)1-9
Number of pages9
JournalBMJ Open
Volume12
Issue number4
Early online date21 Apr 2022
DOIs
Publication statusPublished - 30 Apr 2022

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

  • Paediatrics
  • Heart Defects
  • paediatric cardiology
  • congenital heart disease
  • community child health
  • paediatric surgery
  • Parturition
  • Humans
  • Infant
  • Cardiovascular Agents
  • Drug Prescriptions
  • Pregnancy
  • Congenital/complications
  • Adolescent
  • Ventricular
  • Female
  • Registries
  • Child
  • Cohort Studies
  • Heart Septal Defects

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