Gastrostomy and congenital anomalies: a European population-based study

ABSTRACT Objective To report and compare the proportion of children with and without congenital anomalies undergoinggastrostomy for tube feeding in their first 5 years.Methods A European, population-based data-linkage cohort study (EUROlinkCAT). Children up to 5 years ofage registered in nine EUROCAT registries (national and regional) in six countries and children without congenitalanomalies (reference children) living in the same geographical areas were included. Data on hospitalisationand 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-Hirschhornsyndrome 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.