Epidemiological Features of Infantile Hypertrophic Pyloric Stenosis in Taiwanese Children: A Nation-Wide Analysis of Cases during 1997–2007

Abstract

ObjectiveTo describe the epidemiological characteristics of infantile hypertrophic pyloric stenosis (IHPS) in ethnic Chinese children.Materials and MethodsWe reviewed the National Health Insurance claims database and analyzed data from children less than one year of age who had been diagnosed with IHPS (ICD-9-CM 750.5) and had undergone pyloromyotomy (ICD-9-CM 43.3). We analyzed the incidence, gender, age at diagnosis, length of hospital stay, seasonal variation and cost of IHPS from data collected between January 1997 and December 2007.ResultsA total of 1,077 infants met inclusion criteria, including 889 boys and 188 girls. The annual incidence of IHPS ranged from 0.30 to 0.47 per 1,000 live births with a mean incidence of 0.39 per 1,000 live births. Between 2002 and 2007, the incidence showed a declining trend (P = 0.025) with coincidentally increasing trends for both exclusive breastfeeding (P = 0.014) and breastfeeding plus bottle feeding (P = 0.004). The male-to-female rate ratio was dynamic and increased from 3.03 during the first two weeks of life to 8.94 during the 8th through 10thweeks of life. The overall male-to-female rate ratio was 4.30. The mean age at diagnosis was 43.1±2.4 days. After analyzing the months of birth and hospital admission, no seasonal variation associated with IHPS was detected. The mean length of hospital stay was 8.28±7.10 days.ConclusionsThe incidence of IHPS in Taiwan, a country with a majority ethnic Chinese population, was lower than observed incidences in Caucasian populations living in Western countries. Breastfeeding campaigns and low maternal smoking rates may contribute to the lower incidence of IHPS in Taiwan. However, additional studies with longer follow-up periods are needed.

The Clinical Features of Infantile Hypertrophic Pyloric Stenosis in Chinese Han Population: Analysis from 1998 to 2010

“…To the best of our knowledge, there were no clinical feature analysis reports with IHPS in mainland China, although a lower incidence of IHPS in Chinese has been reported from American, Singapore and Taiwan [6], [9], [10]. Therefore, a retrospective investigation was conducted to describe the clinical features in Chinese infancy.…”

Decline in Infantile Hypertrophic Pyloric Stenosis in Germany in 2000–2008

“…3,4 Epidemiologically, the incidence of IHPS varies widely between different regions and countries, with a higher risk in western industrial countries. 5,6 A white male preponderance (4-5:1) and increased risk in patients' families are well documented. [7][8][9] Young maternal age also appears to be a risk factor, 10 according to recent epidemiologic data from the European surveillance of congenital anomalies (EUROCAT).…”

Correlation of Maternal Age and Migration on IHPS Epidemiology in Germany 2000-2008

“…A potential reason for this finding is the impaired diagnostic ability noted in developing countries (e.g., the absence of an ultrasound) as well as the need to pay closer attention to other causes of infant morbidity and mortality [13], although a lower incidence of IHPS was also found in technically advanced countries such as Taiwan [18]. A study from California found a significant influence even under identical environmental conditions.…”