Musculoskeletal deformities in children with congenital thoracic malformations: a population-based cohort study
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jun 2022 · 1 min read
In brief
In brief
Population-based cohort study of 167 children with congenital thoracic anomalies found significantly increased risk of scoliosis and pectus deformities in CDH and EA/TEF patients compared to controls, but not in congenital lung lesion patients. Findings suggest musculoskeletal deformities are congenital rather than surgery-related, as risk varied by underlying condition rather than surgical approach.
Written by the GCMD Library team from the article.
Purpose: It is unclear if musculoskeletal deformities observed in patients with congenital diaphragmatic hernia (CDH), congenital lung lesion (CLL) and esophageal atresia/tracheoesophageal fistula (EA/TEF) are associated with the anomaly or are a result of the surgery required to treat the anomaly. This study compared the prevalence of musculoskeletal deformities for: (1) children with congenital thoracic anomalies to controls; (2) CLL to EA/TEF both repaired via thoracotomy; and (3) CLL and EA/TEF to CDH repaired via laparotomy.
Methods: We performed a retrospective study of children with CLL, CDH or EA/TEF between 1990 and 2016. Date-of-birth-matched control groups were generated from a population-based dataset. International Classification of Disease codes were used to identify scoliosis and pectus anomalies. We determined Hazard ratios (HR) for cases versus controls.
Results: We included 167 cases (CDH n = 82; CLL n = 29; EA/TEF n = 56) and 1670 controls. EA/TEF had a greater risk of scoliosis (HR 5.52, 95%CI 1.49,13.73) and pectus deformities (HR 4.07, 95%CI 1.96,8.45). CDH showed more scoliosis (HR 5.03, 95%CI 1.99,12.74) but not pectus anomalies. Musculoskeletal deformities were not more common in CLL.
Conclusion: Children born with CDH or EA/TEF, but not CLL, had more musculoskeletal deformities than controls. The inconsistent association between musculoskeletal deformities and the surgical approach suggested a congenital predisposition.
DOI: 10.1016/j.jpedsurg.2021.06.003