RT Journal Article
SR Electronic
T1 Epidemiology of biliary atresia in England and Wales (1999–2006)
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F451
OP F455
DO 10.1136/adc.2009.159780
VO 94
IS 6
A1 E Livesey
A1 M Cortina Borja
A1 K Sharif
A1 N Alizai
A1 P McClean
A1 D Kelly
A1 N Hadzic
A1 M Davenport
YR 2009
UL http://fn.bmj.com/content/94/6/F451.abstract
AB Objective: To identify the epidemiological characteristics of infants with biliary atresia in England and Wales, since centralisation of its management in 1999.Methods: The care of infants with biliary atresia (BA) in England and Wales is centralised to only three centres. All infants (treated from January 1999 to December 2006) were identified from a prospective national database; demographic details were ascertained from medical records and compared between two groups based on presumed aetiology (isolated biliary atresia (IBA) and developmental biliary atresia (DBA) (for example, syndromic infants, biliary atresia splenic malformation, cystic biliary atresia)).Results: There were 302 (133 male (44%)) infants with BA that could be divided into IBA (n = 219, 73%) and DBA (n = 76, 25%). The overall incidence was 0.58/10 000 (1 in 17 049) live births with marked regional differences along a north-west/south-east axis varying from 0.38 (north-west England) to 0.78 (south-east England)/10 000 live births (OR 2.05 (95% CI 1.26–3.41); p = 0.002). The commonest month of birth was September with December being the least common, although there was no evidence for significant seasonal variation (p = 0.2). Infants with DBA were more likely to be female (p<0.001), of white background (p = 0.01), first-born (p = 0.04) and to be formula-fed (p = 0.07). Infants of south Asian origin came to surgery at an older age (59 (IQ 45–75) versus 52 (IQ 42–65) days; p = 0.03).Conclusions: There is a remarkable variation of incidence of biliary atresia within England and Wales, some of which may have been caused by factors related to a different aetiological and racial background.