The burden of disease for children born alive with Turner syndrome—A European cohort study

Ann‐Louise Rud Andersen, Stine Kjaer Urhoj, Joachim Tan, Clara Cavero‐Carbonell, Miriam Gatt, Mika Gissler, Kari Klungsoyr, Babak Khoshnood, Joan Morris, Amanda J. Neville, Anna Pierini, Ieuan Scanlon, Hermien E. K. de Walle, Diana Wellesley, Ester Garne, Maria Loane

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Turner syndrome is a rare congenital anomaly caused by complete or partial X chromosome monosomy that may affect mortality and morbidity in childhood.

This population‐based data‐linkage cohort study, as part of the EUROlinkCAT project, investigated mortality and morbidity for the first 5 years of life for liveborn European children diagnosed with Turner syndrome. Thirteen population‐based registries in 10 countries from the European surveillance of congenital anomalies (EUROCAT) network participated. Data on children born 1995–2014 and diagnosed with Turner syndrome were linked to mortality, hospital and prescription records. Children with any congenital anomaly and children without a congenital anomaly were included for comparison on morbidity.

Out of a population of 5.8 million livebirths 404 were diagnosed with Turner syndrome prenatally or in infancy and 95.5% survived to their fifth birthday. During the first year of life 72.3% (95% CI 59.5;81.6) of children with Turner syndrome were hospitalized, the median length of stay was 5.6 days (95% CI 3.5;7.7) and 18.7% (95% CI 13.9;23.9) underwent surgery. After the first year of life hospitalizations and length of stay decreased but more children underwent surgery (30.8% [95% CI 17.6;44.7]). In the first 5 years the percentage of children with Turner syndrome having a prescription for antibiotics was 12%–20% per year and increased with the age of child.

In the first year of life, the burden of disease was relatively high for children with Turner syndrome. The outlook is more positive beyond the first year, though overall morbidity still exceeded that of children without congenital anomalies.
Original languageEnglish
Pages (from-to)1459-1468
Number of pages10
JournalBirth Defects Research
Issue number16
Early online date26 Jul 2023
Publication statusPublished online - 26 Jul 2023

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. The funders had no role in the study.

Funding Information:
Thanks to Annie Perraud from the JRC-EUROCAT Central Registry, European Commission, Joint Research Centre (JRC), Ispra, Italy, for providing data on the distribution of the codes for Turner syndrome in the EUROCAT central database.

Publisher Copyright:
© 2023 The Authors. Birth Defects Research published by Wiley Periodicals LLC.


  • congenital anomaly
  • morbidity
  • survival
  • Turner syndrome


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