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Oesophageal atresia and tracheo-oesophageal fistula in Western Australia: Prevalence and trends

A recent international study reported a higher prevalence of oesophageal atresia with or without tracheo-oesophageal fistula (OA±TOF) in Western Australia (WA).

Authors:
Leoncini E, Bower C, Nassar N.

Authors notes:
Journal of Paediatrics and Child Health. 2015;51(10):1023-9.

Keywords:
Epidemiology, Oesophageal atresia, Pregnancy, Prevalence, Tracheo-oesophageal fistula

Abstract:
Aim: A recent international study reported a higher prevalence of oesophageal atresia with or without tracheo-oesophageal fistula (OA±TOF) in Western Australia (WA).

The aim of this study was to examine the prevalence and trends of OA and/or TOF in WA, determine the proportion of cases with associated anomalies and explore the impact of time of diagnosis.

Methods: The study population comprised all infants born in WA, 1980-2009, and registered with OA and/or TOF on the WA Register of Developmental Anomalies (WARDA).

Results: OA±TOF and TOF alone affect, on average, one in every 2927 births in WA, with a total prevalence of 3.00 and 0.42 per 10000 births, respectively.

The prevalence of OA±TOF increased by 2.0% per annum, with only cases with associated anomalies (64% of cases) demonstrating an increase.

TOF rates were stable.

Among OA±TOF infants, the proportion of live births, stillbirths and elective terminations of pregnancy for fetal anomaly (TOPFA) was 79%, 6% and 15%, respectively, whereas the majority (94%) of TOF only cases were live births.

In 2000-2009, there was 30% fall in OA±TOF live births with 61 (58%) cases diagnosed in first week of life, 10 (9%) prenatally and 34 (32%) at post-mortem only.

Conclusions: A higher prevalence of OA±TOF in WA was observed with increase over time attributable to increase with associated anomalies.

Consistent reporting, availability of prenatal diagnosis and ascertainment of cases following TOPFA or post-mortem examinations can significantly affect prevalence of OA and/or TOF.