{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:15:36Z","timestamp":1789424136087,"version":"build-2803163510"},"reference-count":53,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Objectives: To investigate the trends in congenital anomalies-related hospital admissions in England and Wales. Methods: This was an ecological study that was conducted using hospital admission data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Congenital malformations, deformations and chromosomal abnormalities hospital admissions data were extracted for the period between April 1999 and March 2019. Results: Hospital admission rate increased by 4.9% [from 198.74 (95% CI 197.53\u2013199.94) in 1999 to 208.55 (95% CI 207.39\u2013209.71) in 2019 per 100,000 persons, trend test, p &lt; 0.01]. The most common hospital admissions causes were congenital malformations of the circulatory system, the musculoskeletal system, genital organs, and the digestive system. The most notable increase in hospital admissions rate was observed in congenital malformations of the respiratory system (1.01-fold). The age group below 15 years accounted for 75.1% of the total number of hospital admissions. Males contributed to 57.5% of the whole number of hospital admission. Hospital admission rate between females was increased by 6.4% [from 162.63 (95% CI 161.10\u2013164.16) in 1999 to 173.05 (95% CI 171.57\u2013174.54) in 2019 per 100,000 persons]. Hospital admission rate between males was increased by 3.4% [from 236.61 (95% CI 234.72\u2013238.50) in 1999 to 244.70 (95% CI 242.92\u2013246.49) in 2019 per 100,000 persons]. Conclusions: Males had a higher percentage of hospitalisation compared to females. Further studies to investigate the factors associated with higher hospitalisation rate among males are needed.<\/jats:p>","DOI":"10.3390\/ijerph182211808","type":"journal-article","created":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T23:02:41Z","timestamp":1636671761000},"page":"11808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Trends of Hospital Admissions Due to Congenital Anomalies in England and Wales between 1999 and 2019: An Ecological Study"],"prefix":"10.3390","volume":"18","author":[{"given":"Abeer F. R.","family":"Alanazi","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical and Biological Sciences, UCL School of Pharmacy, London WC1E 6BT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8440-7446","authenticated-orcid":false,"given":"Abdallah Y.","family":"Naser","sequence":"additional","affiliation":[{"name":"Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca","family":"Pakan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Medical Faculty, University of Nusa Cendana, Kupang 09200, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atheer F.","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Biology, Ministry of Health, Riyadh 11176, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0109-4275","authenticated-orcid":false,"given":"Alyamama Abdulaziz A.","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, School of Biological and Chemical Sciences, Queen Mary University of London, London E1 4NS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra Khalil","family":"Alsairafi","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Kuwait University, Kuwait City 12037, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemah M.","family":"Alsaleh","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Kuwait University, Kuwait City 12037, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,11]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, April 25). Congenital Anomalies. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/congenital-anomalies."},{"key":"ref_2","unstructured":"Sadler, T. (2015). Birth defects and prenatal diagnosis. Langman\u2019s Medical Embryology, Wolters Kluwer."},{"key":"ref_3","unstructured":"World Health Organization (2021, July 01). Birth Defects. Report by the Secretariat. Sixty-Third World Health Assembly., Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/2271."},{"key":"ref_4","first-page":"20","article-title":"Pattern of congenital anomalies in newborn: A hospital-based study","volume":"5","author":"Lebda","year":"2013","journal-title":"Pediatr. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1016\/S0140-6736(16)31012-1","article-title":"Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980\u20132015: A systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"Naghavi","year":"2016","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1002\/bdra.20838","article-title":"A description of congenital anomalies among infants in Entebbe, Uganda","volume":"91","author":"Ndibazza","year":"2011","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"F22","DOI":"10.1136\/archdischild-2016-311845","article-title":"Estimating Global Burden of Disease due to congenital anomaly: An analysis of European data","volume":"103","author":"Boyle","year":"2018","journal-title":"Arch. Dis. Child. Fetal Neonatal Ed."},{"key":"ref_8","first-page":"117","article-title":"Frequencies of congenital anomalies among newborns admitted in nursery of Ayub Teaching Hospital Abbottabad, Pakistan","volume":"23","author":"Gillani","year":"2011","journal-title":"J. Ayub Med. Coll. Abbottabad"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.18203\/2320-6012.ijrms20161758","article-title":"A study of incidence of congenital anomalies in newborn: A hospital based study","volume":"4","author":"Prashar","year":"2016","journal-title":"Int. J. Res. Med Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"651783","DOI":"10.1155\/2014\/651783","article-title":"Major Congenital Malformations in Barbados: The Prevalence, the Pattern, and the Resulting Morbidity and Mortality","volume":"2014","author":"Singh","year":"2014","journal-title":"ISRN Obstet. Gynecol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12887-019-1596-2","article-title":"Congenital anomalies prevalence in Addis Ababa and the Amhara region, Ethiopia: A descriptive cross-sectional study","volume":"19","author":"Taye","year":"2019","journal-title":"BMC Pediatr."},{"key":"ref_12","unstructured":"Public Health England (2021, July 01). National Congenital Anomaly and Rare Disease Registration Service: Congenital Anomaly Statistics 2018, Available online: https:\/\/www.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/630736\/Congenital_anomaly_statistics_2015.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1001\/archpedi.156.4.315","article-title":"Genetic epidemiology and congenital malformations: From the chromosome to the crib","volume":"156","author":"Hobbs","year":"2002","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1590\/S0103-21002007000100004","article-title":"Child with congenital abnormality: Bibliographical study about pediatric nursing publications","volume":"20","author":"Guiller","year":"2007","journal-title":"Acta. Paul. Enferm."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1590\/S0102-311X2005000400008","article-title":"Birth defects and health strategies in Brazil: Sn overview","volume":"21","author":"Horovitz","year":"2005","journal-title":"Cad. Saude Publica"},{"key":"ref_16","unstructured":"Health and Social Care Information Centre (HSCIC) (2021, April 20). Hospital Episode Statistics. Available online: http:\/\/http\/\/content.digital.nhs.uk\/hes."},{"key":"ref_17","unstructured":"NHS Wales Informatics Service (2021, April 20). Annual PEDW Data Tables. Available online: http:\/\/www.infoandstats.wales.nhs.uk\/page.cfm?pid=41010&orgid=869."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s13300-017-0349-1","article-title":"Hospital Admissions due to Dysglycaemia and Prescriptions of Antidiabetic Medications in England and Wales: An Ecological Study","volume":"9","author":"Naser","year":"2018","journal-title":"Diabetes Ther."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Tulloch, J.S.P., Decraene, V., Christley, R.M., Radford, A.D., Warner, J.C., and Vivancos, R. (2019). Characteristics and patient pathways of Lyme disease patients: A retrospective analysis of hospital episode data in England and Wales (1998\u20132015). BMC Public Health, 19.","DOI":"10.1186\/s12889-019-7245-8"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Hemmo, S.I., Naser, A.Y., Alwafi, H., Mansour, M.M., Alanazi, A.F.R., Jalal, Z., Alsairafi, Z.K., Paudyal, V., Alomari, E., and Al-Momani, H. (2021). Hospital Admissions Due to Ischemic Heart Diseases and Prescriptions of Cardiovascular Diseases Medications in England and Wales in the Past Two Decades. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18137041"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Naser, A.Y., Alrawashdeh, H.M., Alwafi, H., AbuAlhommos, A.K., Jalal, Z., Paudyal, V., Alsairafi, Z.K., Salawati, E.M., Samannodi, M., and Sweiss, K. (2021). Hospital Admission Trends due to Viral Infections Characterised by Skin and Mucous Membrane Lesions in the Past Two Decades in England and Wales: An Ecological Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182111649"},{"key":"ref_22","unstructured":"NHS Wales Informatics Service (2021, April 20). Data Quality Status Report: Admitted Patient Care Data Set. Available online: http:\/\/www.infoandstats.wales.nhs.uk\/documents\/869\/20191007-APCDQStatusReport2018-19-v1.pdf."},{"key":"ref_23","unstructured":"Office for National Statistics (ONS) (2021, April 20). Population Estimates, Available online: https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/populationandmigration\/populationestimates\/bulletins\/annualmidyearpopulationestimates\/mid2012tomid2016."},{"key":"ref_24","unstructured":"Public Health England (2021, July 01). NCARDRS Statistics 2018: Summary Report, Available online: https:\/\/www.gov.uk\/government\/publications\/ncardrs-congenital-anomaly-annual-data\/ncardrs-statistics-2018-summary-report."},{"key":"ref_25","first-page":"1","article-title":"Congenital Anomalies Presenting to a Tertiary Neonatal Intensive Care Unit: A Descriptive Study","volume":"1","author":"Siddhisena","year":"2018","journal-title":"J. Birth Defects"},{"key":"ref_26","unstructured":"Department of Health and Social Care (2020). Abortion Statistics, England and Wales: 2019, Department of Health and Social Care."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1161\/CIRCRESAHA.116.309302","article-title":"Changing Landscape of Congenital Heart Disease","volume":"120","author":"Bouma","year":"2017","journal-title":"Circ. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s12687-011-0072-y","article-title":"Consanguineous marriages: Preconception consultation in primary health care settings","volume":"3","author":"Hamamy","year":"2012","journal-title":"J. Community Genet."},{"key":"ref_29","unstructured":"National Institute for Health and Care Excellence (2021, July 01). Risk Factors for Congenital Abnormalities. Eyes on Evidence., Available online: https:\/\/www.evidence.nhs.uk\/search?q=Congenital%20abnormalities&ps=20."},{"key":"ref_30","first-page":"217","article-title":"Advanced Maternal Age and the Risk of Major Congenital Anomalies","volume":"34","author":"Goetzinger","year":"2017","journal-title":"Am. J. Perinatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1007\/s00246-015-1182-9","article-title":"Maternal Hypertension during Pregnancy and the Risk of Congenital Heart Defects in Offspring: A Systematic Review and Meta-analysis","volume":"36","author":"Ramakrishnan","year":"2015","journal-title":"Pediatr. Cardiol."},{"key":"ref_32","first-page":"876","article-title":"Epilepsy drugs and effects on fetal development: Potential mechanisms","volume":"17","author":"Etemad","year":"2012","journal-title":"J. Res. Med. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.ejmhg.2011.02.016","article-title":"Congenital malformations prevalent among Egyptian children and associated risk factors","volume":"12","author":"Shawky","year":"2011","journal-title":"Egypt. J. Med. Hum. Genet."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s42506-018-0004-3","article-title":"Pattern and risk factors of congenital anomalies in a pediatric university hospital, Alexandria, Egypt","volume":"94","author":"Abdou","year":"2019","journal-title":"J. Egypt. Public Health Assoc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/978-90-481-9485-8_20","article-title":"The Prevalence of Congenital Anomalies in Europe","volume":"686","author":"Dolk","year":"2010","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1136\/adc.86.4.257","article-title":"Prevalence and secular trend of congenital anomalies in Glasgow, UK","volume":"86","author":"Dastgiri","year":"2002","journal-title":"Arch. Dis. Child."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Ajao, A., and Adeoye, I. (2019). Prevalence, risk factors and outcome of congenital anomalies among neonatal admissions in OGBOMOSO, Nigeria. BMC Pediatr., 1.","DOI":"10.1186\/s12887-019-1471-1"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1002\/bdra.22846","article-title":"Sex differences in the prevalence of congenital anomalies: A population-based study","volume":"91","author":"Tennant","year":"2011","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/bdra.23218","article-title":"Sex prevalence of major congenital anomalies in the United Kingdom: A national population-based study and international comparison meta-analysis","volume":"100","author":"Sokal","year":"2014","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_40","first-page":"1","article-title":"Gender Difference in Specific Congenital Anomalies","volume":"5","author":"Elghanmi","year":"2017","journal-title":"World J. Res. Rev."},{"key":"ref_41","unstructured":"Royal College of Obstetricians and Gynaecologists (2021, October 27). Termination of Pregnancy for Fetal Abnormality in England, Scotland and Wales. Available online: https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/termination-of-pregnancy-for-fetal-abnormality-in-england-scotland-and-wales\/."},{"key":"ref_42","unstructured":"National Health Service (2021, October 27). 20-Week Screening Scan. Available online: https:\/\/www.nhs.uk\/pregnancy\/your-pregnancy-care\/20-week-scan\/."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1046\/j.1469-0705.1997.09010014.x","article-title":"Ultrasound screening for anencephaly at 10-14 weeks of gestation","volume":"9","author":"Johnson","year":"1997","journal-title":"Ultrasound Obstet. Gynecol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1002\/(SICI)1097-0223(199712)17:13<1269::AID-PD3>3.0.CO;2-G","article-title":"Ultrasound screening for fetal abnormalities in the first trimester","volume":"17","author":"Chitty","year":"1997","journal-title":"Prenat. Diagn."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"17248","DOI":"10.1038\/s41598-019-53655-8","article-title":"Genetic disorder prenatal diagnosis and pregnancy termination practices among high consanguinity population, Saudi Arabia","volume":"9","author":"AbdulAzeez","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.ogrm.2015.08.005","article-title":"Prenatal diagnosis of genetic disorders","volume":"25","author":"Hamilton","year":"2015","journal-title":"Obstet. Gynaecol. Reprod. Med."},{"key":"ref_47","unstructured":"National Institute for Health and Care Excellence (2021, October 25). Abortion Care. Available online: https:\/\/www.nice.org.uk\/guidance\/ng140\/chapter\/Recommendations."},{"key":"ref_48","unstructured":"Public Health England (2017). National Congenital Anomaly and Rare Disease Registration Service. Congenital Anomaly Statistics 2015, Public Health England."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1002\/ajmg.1320270304","article-title":"Congenital anomalies: Mortality and morbidity, burden and classification","volume":"27","author":"Chung","year":"1987","journal-title":"Am. J. Med. Genet."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/S0140-6736(05)67459-4","article-title":"The global challenges of birth defects and disabilities","volume":"366","author":"Carmona","year":"2005","journal-title":"Lancet"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1007\/s00268-014-2714-9","article-title":"Congenital Anomalies in Low- and Middle-Income Countries: The Unborn Child of Global Surgery","volume":"39","author":"Sitkin","year":"2015","journal-title":"World J. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1016\/S0140-6736(12)61878-9","article-title":"Global regional and national causes of child mortality","volume":"380","author":"Modell","year":"2012","journal-title":"Lancet"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1007\/s12687-017-0335-3","article-title":"An overview of concepts and approaches used in estimating the burden of congenital disorders globally","volume":"9","author":"Moorthie","year":"2017","journal-title":"J. Community Genet."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/22\/11808\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:28:29Z","timestamp":1760167709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/22\/11808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,11]]},"references-count":53,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["ijerph182211808"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182211808","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,11]]}}}