title: Morbidity due to acute lower respiratory infection in children with birth defects: a total population-based linked data study.
abstract: BACKGROUND
  Acute lower respiratory infections (ALRIs) are leading causes of hospitalisation in children. Birth defects occur in 5% of live births in Western Australia (WA). The association between birth defects and ALRI hospitalisation is unknown.
  
  
  METHODS
  We conducted a retrospective cohort study of 245,249 singleton births in WA (1996-2005). Population-based hospitalisation data were linked to the WA Register of Developmental Anomalies to investigate ALRI hospitalisations in children with and without birth defects. We used negative binomial regression to estimate associations between birth defects and number of ALRI hospitalisations before age 2 years, adjusting for known risk factors.
  
  
  RESULTS
  Overall, 9% of non-Aboriginal children and 37% of Aboriginal children with birth defects had at least one ALRI admission before age 2 years. Aboriginal children (IRR 2.3, 95% CI: 1.9-2.8) and non-Aboriginal children (IRR 2.0, 95% CI: 1.8-2.2) with birth defects had higher rates of hospitalisation for an ALRI than children with no birth defects. Rates of ALRI hospitalisation varied by type of defect but were increased for all major birth defects categories, the highest rate being for children with Down syndrome (IRR 8.0, 95% CI: 5.6-11.5). The rate of ALRI hospitalisation was 3 times greater in children with multiple birth defects than in those with isolated defects.
  
  
  CONCLUSIONS
  Children with birth defects experience higher rates of hospitalisation for ALRIs before age 2 years than children with no birth defects. Optimal vaccination coverage and immunoprophylaxis for specific categories of birth defects would assist in reducing hospitalisation rates for ALRI.
authors.forename: Khadra A
authors.initials: KA
authors.lastname: Jama-Alol
authors.affiliation: Telethon Kids Institute, The University of Western Australia, Perth, Western Australia. hannah.moore@telethonkids.org.au.
authors.forename: Hannah C
authors.initials: HC
authors.lastname: Moore
authors.forename: Peter
authors.initials: P
authors.lastname: Jacoby
authors.forename: Carol
authors.initials: C
authors.lastname: Bower
authors.forename: Deborah
authors.initials: D
authors.lastname: Lehmann
mesh_terms: D000208:Acute Disease; D015331:Cohort Studies; D000013:Congenital Abnormalities; D003625:Data Collection; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012141:Respiratory Tract Infections / Q000150:complications* / Q000628:therapy; D012189:Retrospective Studies; D014904:Western Australia