Abstract
Background:
The indicator “congenital anomalies typically requiring surgery” (CARS) has not previously been documented for New Zealand, yet such anomalies place considerable burden on families and the health sector, for example, from lengthy stays in hospital or high fiscal costs. If treated with cost-effective surgical procedures, children with these anomalies have an improved long-term prognosis.
This study describes the prevalence of CARS among total births (livebirths and fetal deaths) in New Zealand for the years 2000–2011.
Methods:
Information held in the National Minimum Dataset and the National Mortality Collection was used to identify cases of CARS. The selection comprised babies born live in hospital or fetal deaths with an ICD-10-AM diagnosis of: craniosynostosis, gastroschisis, omphalocele, severe congenital heart disease, digestive system malformations, or orofacial cleft. These anomalies were defined by EUROCAT (European network for the surveillance of congenital anomalies) for having a high pregnancy survival rate and a high requirement for surgery before the age of one year.
Results:
The birth prevalence of CARS was 4.11 per 1,000 births for 2000–2011. The most common CARS were orofacial clefts, severe congenital heart disease, and digestive malformations. The temporal trend was essentially stable for CARS, and only gastroschisis was significantly higher in 2011 than in 2000.
Conclusion:
The prevalence of CARS in New Zealand is comparable to rates observed for the English EUROCAT registers; however, the stable trend contrasts to the decreases seen for Europe. The requirement for paediatric surgical services is not presently monitored for New Zealand. This study highlights the continued need for these services; in particular, the increasing need for urgent post-delivery surgery for babies born with gastroschisis.
This study reports CARS as diagnosed at birth, and consequently may underestimate prevalence. Extension of the indicator criteria from birth to diagnosis up to one year of age, and identification of terminations of pregnancy for fetal anomaly, warrant further investigation.