A database study of contemporary diagnosis and management among infants with congenital lung malformations in the United States

Congenital lung malformations (CLM) are commonly screened for on prenatal diagnostic testing and are an index pediatric surgical condition. Population-level contemporary data on incidence and management of CLMs in the United States remain limited. The objective was to evaluate the national prevalence in CLM among live births and resection rates among infants. This retrospective analysis used MarketScan Commercial Database. ICD-10 codes were used to identify patients with CLM (2017–2023), confirmed by cross-sectional chest imaging Current Procedural Code (CPT). We identified 2.15 cases per 10,000 patients. CLM incidence rose from 1.80 per 10,000 in 2017 to a peak of 2.67 in 2020. In a multivariate model, prevalence of CLM diagnosis did not significantly change with year of birth or sex, but living in the Southern United States was associated with lower prevalence of diagnosis (aPR = 0.72 (95% CI 0.53–0.97), p = 0.03). Among CLM patients, 47.72% underwent resection, most commonly during the first year of life (96.18%). Over the time course of the study period, we observed a trend in decreased resection rates. Of those who underwent resection, 21.21% received care in a state different from their home state. This is the first contemporary, population-based study of CLM occurrence among United States infants. The migration of care may reshape healthcare utilization and has equity implications.