Incidence of Esophageal Atresia and Associated Respiratory Morbidity in Children: A National Registry Study in Denmark (1998–2018)

Introduction: This national study aimed to assess the incidence and respiratory morbidity in children with esophageal atresia (EA). Methods: We conducted a national population-based cohort study from 1998 to 2018 using the National Patient Registry to identify children with EA and calculated the annual incidence. Respiratory morbidity was evaluated through healthcare utilization and prescribed therapy. A case–control analysis linked to the Prescription Registry compared lung disease management in EA patients to age-matched children with asthma, and a control group from the background population. Results: The incidence of EA remained stable at 2.5 cases per 10,000 births, with a 20-year mortality rate of 4%. Children with EA exhibited higher antibiotic use, with an average of 3.2 prescriptions per year, compared to 2.1 in the asthma group (p < 0.01) and 1.75 in the control group (p < 0.01). Use of beta-2 agonists was similar between the EA and asthma group, with 2.7 and 2.3 prescriptions per year, respectively. Compared to the controls inhaled corticosteroid use was also elevated in children with EA (p < 0.01), averaging 3.5 prescriptions per year, and approaching 3.1 prescriptions per year observed in children with asthma (p < 0.01). Children with EA had more healthcare contacts averaging 4.8 per year, more than both asthma 2.2 and controls 1.7 (p < 0.01), which were not solely related to esophageal complications. Conclusion: The incidence of EA has remained stable and children with EA experience higher respiratory morbidity in early life compared to peers with asthma or those without chronic illness. This disparity diminishes with age, particularly during adolescence.