Asthma in Children With Congenital Lung Malformations: A Population‐Based Case‐Control Study
Louis W. J. Dossche, Ghazale Farjam, Marius J. P. Zuidweg, Shaikh Iqbal, J. Marco Schnater, Suyin A. Lum Min, Richard KeijzerABSTRACT
Background
Congenital lung malformations (CLM) are developmental anomalies that may predispose to respiratory morbidity. Their association with asthma remains unclear, largely due to small series and the lack of population‐based controls.
Objective
To evaluate asthma prevalence and related outcomes in children with CLM compared to population controls.
Methods
We conducted a population‐based case‐control study linking CLM patients from a surgical registry to provincial health data. Each CLM patient was linked to up to ten date‐of‐birth‐matched controls. Asthma was defined by ICD‐9/10 codes from age ≥5 years. Outcomes included asthma prevalence, time to first diagnosis, recurrent medical encounters, and pharmacotherapy patterns. Analyses yielded risk ratios (RR), adjusted hazard ratios (aHR), and adjusted incidence rate ratios (aIRR).
Results
Forty‐nine CLM cases and 486 controls were included. Asthma was diagnosed in 19 (38.8%) CLM cases versus 76 (15.6%) controls (RR = 2.48, 95% CI [1.65–3.73]; p < 0.001). The RR did not differ between surgically and conservatively managed CLM cases (RR = 2.87, 95% CI [0.45–18.32]; p = 0.234). CLM cases had a threefold higher hazard of asthma (aHR = 3.24, 95% CI [1.84–5.71]; p < 0.001). Female cases were particularly affected (aHR = 3.92, 95% CI [1.98–7.74]; p < 0.001), with no difference observed in males (aHR = 1.98, 95% CI [0.90–4.37]; p = 0.092). Annually, CLM patients accumulated 71% more asthma‐related encounters (aIRR = 1.71, 95% CI [1.28–2.25]; p < 0.001).
Conclusions
Children with CLM are at increased risk of asthma, especially females, with earlier onset and more frequent encounters. These findings highlight the need for long‐term respiratory follow‐up and objective validation of asthma diagnoses in this population.