Healthcare Utilization and Comorbidities Associated with Anorectal Malformations in the United States

Kovačić, Karlo; Matta, Sravan; Calkins, Casey M.; Yan, Ke; Sood, Manu R.

doi:10.1016/j.jpeds.2017.10.010

Cited by 15 publications

(9 citation statements)

References 17 publications

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“…The rate of associated malformation with ARM in our series (68.1%) is high but it is in agreement with the current literature. 27 In our ARM patients, the high incidence of concomitant urogenital, cardiac and spinal malformations and the low incidence of gastrointestinal, skeletal or CNS anomalies are comparable to several other studies. Nonetheless, the occurrence of ARM as a component of VACTERL association appeared to be less common than in previous studies.…”

Section: Abnormalities Of Arm Children and Occurrence Of Associated Msupporting

confidence: 90%

Risk factors for anorectal and associated malformations in German children: A 10-year analysis

Kapapa

Becker

Serra

2021

Pediatrics & Neonatology

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Background: Incidences of anorectal malformations (ARM) occur in 1 of 2000e5000 live births and up to 64% have associated malformations (ARMa). The aim of the study was to evaluate possible prenatal risk factors for ARM in a tertiary hospital. Methods: A caseecontrol design was used to compare risk factors in ARM (n Z 44) to a control group (CG; n Z 26). We used modified prenatal questionnaires, analyzed mothers' prenatal records and participants completed a structured interview. Endpoints were medical history, drug consumption, occupational risk factors, and time point of diagnosis, associated malformations and sensitivity of radiological imaging. Results: Our results showed that ARM couples had a significantly higher age difference (p Z 0.028) compared to CG. ARM mothers had more abnormalities during pregnancy (p Z 0.002), more positive vaginal smears of group B streptococci (p Z 0.024), urogenital infections (p Z 0.005), gestosis (p Z 0.03), emesis (p Z 0.025) and higher numbers of chronic diseases (p Z 0.018). ARM mothers took less medication during pregnancy (p Z 0.013) than CG mothers including folic acid (p Z 0.041); their intake of iodine tablets was significantly higher (p Z 0.035) and they continued smoking for longer (p Z 0.036) than CG mothers, and they had more stillbirths (p Z 0.035). In using illegal drug and alcohol use, the groups did not show significant differences. ARMa was present in 68.1% (n Z 30), of which 45.5% were of urogenital origin (n Z 20). ARM diagnosis was made on the first day of life in 72.7% (n Z 32), while diagnosis was delayed in 12 patients (27.3%). Conclusion: A combination of different risk factors seem to be associated with the development of ARM, which takes place at an early stage (<7th week) of pregnancy. Therefore, risk factors influencing fetal development must be critically considered. We advocate an

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Section: Abnormalities Of Arm Children and Occurrence Of Associated Msupporting

confidence: 90%

Risk factors for anorectal and associated malformations in German children: A 10-year analysis

Kapapa

Becker

Serra

2021

Pediatrics & Neonatology

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“…Imperforate anus (IA), an anorectal malformation, is a rare congenital anomaly found in the lowest portion of the intestinal and urogenital tracts. The incidence of anorectal malformations varies from 2–2.5 per 10,000 live births, with considerable variations across regions worldwide [1,2] . The concept of caudal repression may apply to anogenital anomalies of the anus, which might predict a higher incidence of anomalies of the lower spine and genitourinary tract in association with IA [3] .…”

Section: Introductionmentioning

confidence: 99%

Risk factors of vesicoureteral reflux and urinary tract infections in children with imperforate anus

Wei

Lin

et al. 2021

Medicine

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Imperforate anus (IA) is associated with several urological anomalies, including vesicoureteral reflux (VUR), a major contributor to high morbidity in patients with anorectal malformations. This retrospective study was performed to elucidate the risk factors of vesicoureteral reflux (VUR) and UTI in children with IA.We used the National Health Insurance Research Database (NHIRD) to estimate the frequency of congenital anomalies of the kidney and urinary tract (CAKUT) in children with IA. We also investigated the frequencies of VUR, UTI, and CAKUT in children with IA along with the risk factors of VUR.We enrolled 613 children between 2000 and 2008 (367 males and 246 females; 489 low-position IA and 124 high-position IA). High-position IA was associated with a significantly increased risk of VUR compared with low-position IA (OR: 2.68, 95% CI: 1.61, 4.45). In addition, children with IA along with CAKUT, hydronephrosis, or UTI had a higher risk of VUR (OR: 8.57, 95% CI: 3.75, 19.6; OR: 7.65, 95% CI: 4.48, 13.1; and OR: 31.8, 95% CI: 11.5, 88.3, respectively). UTI, as well as chromosomal anomalies, were more frequent in children with high-position IA.Patients with a high-position IA had a greater risk of VUR, particularly those with CAKUT, hydronephrosis, or UTI. Such patients must periodically undergo urinalysis to screen for UTI and early voiding cystourethrogram to rule out VUR and prevent consequent renal damage. Chromosomal analysis is suggested to rule out Down syndrome.

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“…We used a nationally representative and validated birth cohort known to include 97% of all births in England19 to conduct the largest study to date quantifying anorectal malformation birth prevalence. Despite the rarity of anorectal malformations, the size of our study allowed us to investigate heterogeneity in the characteristics, potential risk factors and 5-year survival of isolated and complex phenotypes.…”

Section: Discussionmentioning

confidence: 99%

“…Paediatric surgeons (KF and JIC) extracted diagnostic and operation codes from previous studies using administrative healthcare data to identify anorectal malformations and categorised them as specific or generic for gastrointestinal disorders5 18 19 (online supplemental table 2). Differential diagnosis codes used to exclude cases unlikely to have anorectal malformations were also defined.…”

Section: Methodsmentioning

confidence: 99%

Birth prevalence of anorectal malformations in England and 5-year survival: a national birth cohort study

et al. 2022

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ObjectiveTo determine the birth prevalence, maternal risk factors and 5-year survival for isolated and complex anorectal malformations.DesignNational birth cohort using hospital admission data and death records.SettingAll National Health Service England hospitals.PatientsLive-born singletons delivered from 2002 through 2018, with evidence in the first year of life of a diagnosis of an anorectal malformation and repair during a hospital admission, or anorectal malformation recorded on the death certificate. Cases were further classified as isolated or complex depending on the presence of additional anomalies.Main outcome measuresBirth prevalence of anorectal malformations per 10 000 live births, risk ratios for isolated and complex anorectal malformation by maternal, infant and birth characteristics, and 5-year survival.ResultsWe identified 3325 infants with anorectal malformations among 9 474 147 live-born singletons; 61.7% (n=2050) of cases were complex. Birth prevalence was 3.5 per 10 000 live births (95% CI 3.4 to 3.6). Complex anorectal malformations were associated with maternal age extremes after accounting for other sociodemographic factors. Compared with maternal ages 25–34 years, the risk of complex anorectal malformations was 31% higher for ≥35 years (95% CI 17 to 48) and 13% higher for ≤24 years (95% CI 0 to 27). Among 2376 anorectal malformation cases (n=1450 complex) born from 2002 through 2014, 5-year survival was lower for complex (86.9%; 95% CI 85.1% to 88.5%) than isolated anorectal malformations (98.2%; 95% CI 97.1% to 98.9%). Preterm infants with complex anorectal malformations had the lowest survival (73.4%; 95% CI 68.1% to 78.0%).ConclusionsDifferences in maternal risk factors for isolated and complex anorectal malformations may reflect different underlying mechanisms for occurrence. Five-year survival is high but lowest for preterm children with complex anorectal malformations.

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Healthcare Utilization and Comorbidities Associated with Anorectal Malformations in the United States

Cited by 15 publications

References 17 publications

Risk factors for anorectal and associated malformations in German children: A 10-year analysis

Risk factors for anorectal and associated malformations in German children: A 10-year analysis

Risk factors of vesicoureteral reflux and urinary tract infections in children with imperforate anus

Birth prevalence of anorectal malformations in England and 5-year survival: a national birth cohort study

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