A Multicountry Analysis of Prevalence and Mortality among Neonates and Children with Bladder Exstrophy

Author:

Kancherla Vijaya1,Tandaki Lucita2ORCID,Sundar Manasvi1,Lux Anke3,Bakker Marian K4,Bergman Jorieke EH4,Bermejo-Sánchez Eva5,Canfield Mark A6,Feldkamp Marcia L7,Groisman Boris8,Hurtado-Villa Paula9,Källén Karin10,Landau Danielle11,Lelong Nathalie12,Lopez-Camelo Jorge13ORCID,Mastroiacovo Pierpaolo14,Morgan Margery15,Mutchinick Osvaldo M16,Nance Amy E17,Nembhard Wendy N18,Pierini Anna19,Šípek Antonin20,Stallings Erin B21,Szabova Elena22,Wertelecki Wladimir23,Zarante Ignacio24,Rissmann Anke2ORCID

Affiliation:

1. Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia

2. Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Germany

3. Institute for Biometrics and Medical Informatics, Medical Faculty, Otto-von-Guericke-University, Magdeburg, Germany

4. Department of Genetics, University of Groningen, University Medical Center Groningen, Eurocat Northern The Netherlands, Groningen, The Netherlands

5. ECEMC (Spanish Collaborative Study of Congenital Malformations), UIAC (Unidad de Investigación sobre Anomalías Congénitas), Instituto de Investigación de Enfermedades Raras (IIER). Instituto de Salud Carlos III. Madrid, Spain

6. Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas

7. Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah

8. National Network of Congenital Anomalies of Argentina (RENAC), National Center of Medical Genetics, National Administration of Laboratories and Health Institutes (ANLIS), National Ministry of Health, Buenos Aires, Argentina

9. Department of Basic Sciences of Health, School of Health, Pontificia Universidad Javeriana Cali, Colombia and Clínica Imbanaco, Cali, Colombia

10. National Board of Health and Welfare, Stockholm, Sweden

11. Department of Neonatology, Soroka Medical Center, Beer-Sheva, Israel

12. Université de Paris, Inserm U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS) Paris, France

13. ECLAMC, Center for Medical Education and Clinical Research (CEMIC-CONICET), Buenos Aires, Argentina

14. International Center on Birth Defects, International Clearinghouse for Birth Defects Surveillance and Research, Rome, Italy

15. CARIS, the Congenital Anomaly Register for Wales, Singleton Hospital, Swansea, Wales, United Kingdom

16. RYVEMCE (Registry and Epidemiologic Surveillance of Congenital Malformations), Department of Genetics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico

17. Utah Department of Health, Bureau of Children with Special Health Care Needs, Utah Birth Defects Network, Salt Lake City, Utah

18. Arkansas Center for Birth Defects Research and Prevention and Arkansas Reproductive Health Monitoring System, University of Arkansas for Medical Sciences, Fay Boozman College of Public Health, Department of Epidemiology, Little Rock, Arkansas

19. Institute of Clinical Physiology, National Research Council and Fondazione Toscana Gabriele Monasterio, Tuscany Registry of Congenital Defects, Pisa, Italy

20. Department of Medical Genetics, Thomayer Hospital, Prague, Czech Republic

21. Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia

22. Slovak Teratologic Information Centre (FPH), Slovak Medical University, Bratislava, Slovak Republic

23. OMNI-Net Ukraine, Rivne, Ukraine

24. Human Genetics Institute, Pontificia Universidad Javeriana, Bogotá, Colombia and Hospital Universitario San Ignacio, Bogotá, Colombia

Abstract

Objective Bladder exstrophy (BE) is a rare but severe birth defect affecting the lower abdominal wall and genitourinary system. The objective of the study is to examine the total prevalence, trends in prevalence, and age-specific mortality among individuals with BE. Study Design We conducted a retrospective cohort study. Data were analyzed from 20 birth defects surveillance programs, members of the International Clearinghouse for Birth Defects Surveillance and Research in 16 countries. Live births, stillbirths, and elective terminations of pregnancy for fetal anomaly (ETOPFA) diagnosed with BE from 1974 to 2014. Pooled and program-specific prevalence of BE per 100,000 total births was calculated. The 95% confidence intervals (CI) for prevalence were estimated using Poisson approximation of binomial distribution. Time trends in prevalence of BE from 2000 to 2014 were examined using Poisson regression. Proportion of deaths among BE cases was calculated on the day of birth, day 2 to 6, day 7 to 27, day 28 to 364, 1 to 4 years, and ≥5 years. Mortality analysis was stratified by isolated, multiple, and syndromic case status. Results The pooled total prevalence of BE was 2.58 per 100,000 total births (95% CI = 2.40, 2.78) for study years 1974 to 2014. Prevalence varied over time with a decreasing trend from 2000 to 2014. The first-week mortality proportion was 3.5, 17.3, and 14.6% among isolated, multiple, and syndromic BE cases, respectively. The majority of first-week mortality occurred on the first day of life among isolated, multiple, and syndromic BE cases. The proportion of first-week deaths was higher among cases reported from programs in Latin America where ETOPFA services were not available. Conclusions Prevalence of BE varied by program and showed a decreasing trend from 2000 to –2014. Mortality is a concern among multiple and syndromic cases, and a high proportion of deaths among cases occurred during the first week of life. Key Points

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health

Reference27 articles.

1. Bladder exstrophy;S Uludag;Fetal Pediatr Pathol,2012

2. Bladder exstrophy-epispadias complex;M Ludwig;Birth Defects Res A Clin Mol Teratol,2009

3. Prenatal sonographic findings in bladder exstrophy;R A Barth;J Ultrasound Med,1990

4. Embryogenesis of bladder exstrophy: a new hypothesis;B Kulkarni;J Indian Assoc Pediatr Surg,2008

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. MR Imaging of the Fetal Genitourinary Tract;Magnetic Resonance Imaging Clinics of North America;2024-08

2. Achieving goal capacity for continence surgery: A cumulative event analysis of bladder exstrophy patients;Journal of Pediatric Urology;2023-10

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