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

Abstract

ObjectivesAdvances 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.DesignPopulation-based cohort study.SettingSix 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.ParticipantsWe 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.ResultsChildren 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).ConclusionAlmost 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.

Preterm birth and prescriptions for cardiovascular, antiseizure, antibiotics and antiasthmatic medication in children up to 10 years of age: a population-based data linkage cohort study across six European regions

“…As previously described in detail in Damkjaer et al , 12 antiarrhythmic medication is classified according to the Vaughan Williams classification (VWC). 13 Antihypertensive medication and diuretics were classified according to the Anatomical Therapeutic Classification (ATC) system codes reported in the electronic prescription databases.…”

Higher risk of cerebral palsy, seizures/epilepsy, visual‐ and hearing impairments, cancer, injury and child abuse in children with congenital anomalies: Data from the EUROlinkCAT study

“…Population‐based studies have shown that children with congenital anomalies are more frequently hospitalised and that, on average, they spend more time in hospital than children without congenital anomalies 6 . Similarly, these children were prescribed more cardiovascular medication 7 and were 80 times more likely to receive a gastrostomy feeding tube than children without congenital anomalies 8 . A higher risk of cancer has been consistently found in children with congenital anomalies, and especially in children with chromosomal anomalies 9–12 .…”