Patterns of malformation associated with esophageal atresia/tracheoesophageal fistula: A retrospective single center study

Am J Med Genet A. 2020 Jun;182(6):1351-1363. doi: 10.1002/ajmg.a.61582. Epub 2020 Apr 6.

Abstract

Esophageal atresia/tracheoesophageal fistula (EA/TEF) is one of the most common gastrointestinal birth defects. It can occur in isolation or in association with other birth defects or genetic syndromes. We retrospectively reviewed the EA/TEF cases evaluated at Rady Children's Hospital San Diego (San Diego, CA) between 2007 and 2016. Data were collected for 157 patients. The majority of patients (105, 66.8%) had an associated major malformation present, and 52 patients (33.1%) had isolated EA/TEF. The patients with associated malformations were distributed as follows: 16 patients (10.2%) had a known genetic syndrome (the most common being Trisomy 21 in 11 patients); six patients (3.8%) had a suspected genetic syndrome; one patient had a suspected teratogenic syndrome (diabetic embryopathy); 30 patients had VACTERL association (19.1%); 32 patients had a "partial VACTERL" association (only two VACTERL-type defects without other malformation); nine patients (5.7%) had one additional non-VACTERL-type birth defect, two patients had VACTERL-type defects plus auricular malformations; and nine patients (5.7%) were classified as "unknown syndrome." A classification of the patterns of malformation of patients with congenital EA/TEF is proposed based on reviewing the data of this relatively large and phenotypically diverse patient group.

Keywords: VACTERL; associated anomalies; esophageal atresia (EA); pattern of malformation; tracheoesopageal fistula (TEF).

MeSH terms

  • Abnormalities, Multiple / epidemiology*
  • Abnormalities, Multiple / genetics
  • Adult
  • Anal Canal / abnormalities*
  • Down Syndrome / complications
  • Down Syndrome / epidemiology
  • Down Syndrome / genetics
  • Esophageal Atresia / complications
  • Esophageal Atresia / epidemiology*
  • Esophageal Atresia / genetics
  • Esophagus / abnormalities*
  • Female
  • Fetal Diseases / epidemiology
  • Fetal Diseases / genetics
  • Fetal Diseases / pathology
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / epidemiology*
  • Heart Defects, Congenital / genetics
  • Humans
  • Infant, Newborn
  • Kidney / abnormalities*
  • Limb Deformities, Congenital / complications
  • Limb Deformities, Congenital / epidemiology*
  • Limb Deformities, Congenital / genetics
  • Male
  • Maternal Age
  • Retrospective Studies
  • Spine / abnormalities*
  • Trachea / abnormalities*
  • Tracheoesophageal Fistula / complications
  • Tracheoesophageal Fistula / epidemiology*
  • Tracheoesophageal Fistula / genetics

Supplementary concepts

  • VACTERL association