The incidence of infantile hypertrophic pyloric stenosis and its association with folic acid supplementation during pregnancy: A nested case–control study

Rosenthal, Yael Shalev; Chodick, Gabriel; Grossman, Zachi; Shalev, Varda; Koren, Gideon

doi:10.1016/j.jpedsurg.2018.05.005

Cited by 18 publications

(14 citation statements)

References 27 publications

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“…The differences between these 2 rates may be because of the different databases used for these studies and the different time periods during which these studies were conducted. Kapoor et al 8 also noted that the incidence rate of IHPS declined from 2.5 to 1.7 per 1000 live births The declining rate of IHPS has also been reported in other Western countries 11,12,35,36. Factors such as young maternal age, preterm birth, maternal smoking, bottle-feeding with formula, and macrolide antibiotic exposure in first 2 weeks of life have been strongly associated with IHPS.…”

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confidence: 87%

Pyloric Stenosis: National Trends in the Incidence Rate and Resource Use in the United States From 2012 to 2016

Donda

Asare‐Afriyie

Ayensu³

et al. 2019

Hospital Pediatrics

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Infantile hypertrophic pyloric stenosis (IHPS) is the most common reason for abdominal surgery in infants; however, national-level data on incidence rate and resource use are lacking. We aimed to examine the national trends in hospitalizations for IHPS and resource use in its management in the United States from 2012 to 2016. METHODS:We performed a retrospective serial cross-sectional study using data from the National Inpatient Sample, the largest health care database in the United States. We included infants aged #1 year assigned an International Classification of Diseases, Ninth Revision, or International Classification of Diseases, 10th Revision, code for IHPS who underwent pyloromyotomy or pyloroplasty. We examined the temporal trends in the incidence rate (cases per 1000 live births) according to sex, insurance status, geographic region, and race. We examined resource use using length of stay (LOS) and hospital costs. Linear regression was used for trend analysis. RESULTS:Between 2012 and 2016, there were 32 450 cases of IHPS and 20 808 149 live births (incidence rate of 1.56 per 1000). Characteristics of the study population were 82.7% male, 53% white, and 63.3% on Medicaid, and a majority were born in large (64%), urban teaching hospitals (90%). The incidence of IHPS varied with race, sex, socioeconomic status, and geographic region. In multivariable regression analysis, the incidence rate of IHPS decreased from 1.76 to 1.57 per 1000 (adjusted odds ratio 0.93; 95% confidence interval 0.92-0.93). The median cost of care was $6078.30, whereas the median LOS was 2 days, and these remained stable during the period. CONCLUSIONS:The incidence rate of IHPS decreased significantly between 2012 and 2016, whereas LOS and hospital costs remained stable. The reasons for the decline in the IHPS incidence rate may be multifactorial.

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confidence: 87%

Pyloric Stenosis: National Trends in the Incidence Rate and Resource Use in the United States From 2012 to 2016

Donda

Asare‐Afriyie

Ayensu³

et al. 2019

Hospital Pediatrics

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“…3,13,14 Since 1990, a decline in incidence of IHPS has been reported in several countries. [12][13][14][26][27][28][29][30] Most recent incidence rates of IHPS in Europe are 0.6 per 1,000 LB in Sweden (2014) and 2.02 per 1,000 LB in Germany (2012). 12,14 In the United States and Israel, 30,31 We found a lower incidence of IHPS in the Netherlands of 1.28 per 1,000 LB compared with other countries.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to earlier studies showing a declining trend, we found no uniform trend in incidence over time. [12][13][14]19,[26][27][28][29][30] A couple of studies have investigated different potential causes of the declining IHPS incidence, such as changes in sleeping position and folic acid consumption, but no association was found. 9,27,30 Known risk factors for IHPS are male sex, formula feeding, birth by cesarean section, preterm birth, multiple birth, macrolide exposure, and maternal smoking.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14]19,[26][27][28][29][30] A couple of studies have investigated different potential causes of the declining IHPS incidence, such as changes in sleeping position and folic acid consumption, but no association was found. 9,27,30 Known risk factors for IHPS are male sex, formula feeding, birth by cesarean section, preterm birth, multiple birth, macrolide exposure, and maternal smoking. [3][4][5]14,[31][32][33] McAteer et al showed a decrease in incidence of IHPS from 1.4 per 1,000 LB in 2003 to 0.9 per 1,000 LB in 2009, while the prevalence of breastfeeding at birth discharge increased from 80 to 94%.…”

Section: Discussionmentioning

confidence: 99%

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The Dutch Incidence of Infantile Hypertrophic Pyloric Stenosis and the Influence of Seasons

et al. 2020

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Introduction Studies report contradicting results on the incidence of infantile hypertrophic pyloric stenosis (IHPS) and its association with seasons. We aim to assess the IHPS incidence in the Netherlands and to determine whether seasonal variation is present in a nationwide cohort. Materials and Methods All infants with IHPS hospitalized in the Netherlands between 2007 and 2017 were included in this retrospective cohort study. Incidence rates per 1,000 livebirths (LB) were calculated using total number of LB during the matched month, season, or year, respectively. Seasonal variation based on month of birth and month of surgery was analyzed using linear mixed model and one-way ANOVA, respectively. Results A total of 2,479 infants were included, of which the majority was male (75.9%). Median (interquartile range) age at surgery was 34 (18) days. The average IHPS incidence rate was 1.28 per 1,000 LB (variation: 1.09–1.47 per 1,000 LB). We did not find a conclusive trend over time in IHPS incidence. Differences in incidence between season of birth and season of surgery were not significant (p = 0.677 and p = 0.206, respectively). Conclusion We found an average IHPS incidence of 1.28 per 1,000 LB in the Netherlands. Our results showed no changing trend in incidence and no seasonal variation.

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“…1 This condition is most commonly found in first-born males with a reported ratio of males to females of 4:1. 2 The incidence of IHPS has been reported to range from 0.5 to 5 per 1 000 live births and is more common in Western countries 3 than in African countries. 4 Trends in different European regions are conflicting as to whether the disease is increasing or decreasing.…”

Section: Introductionmentioning

confidence: 99%

Infantile hypertrophic pyloric stenosis: profile, management and outcome of patients admitted to a tertiary hospital in Bloemfontein, South Africa

et al. 2019

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Background: Infantile hypertrophic pyloric stenosis (IHPS) is the thickening of both muscle layers of the pylorus and is most commonly found in first-born males. It usually presents with projectile, non-bilious vomiting. Late presentation leads to severe dehydration and malnutrition with deranged serum-electrolytes and acid-base imbalance delaying treatment and prolonging hospital stay. This study aims to evaluate the profile, management and outcome of IHPS at a tertiary hospital in Bloemfontein, South Africa. Methods: The study was a retrospective, descriptive record review including all patients with IHPS admitted to Universitas Hospital from January 2008 to February 2016. Of the 22 patients admitted, files for 19 patients were available for inclusion. Results: Sixteen (84.2%) of the 19 patients were male. Of the 11 patients with available birth order, two were first-, two second-, six third-and one fourth-born. The patients' ages ranged from 27 to 194 days (median 51 days). The most common symptoms were projectile vomiting (78.9%) and poor weight gain (68.4%). Six patients had no ultrasound done, and 17 patients underwent a Ramstedt-pyloromyotomy. Eight patients received atropine as part of their initial management. The duration of symptoms ranged from 1 to 58 days (median 14 days). There was no reported mortality. The length of stay ranged from 2 to 60 days (median 7 days). Conclusion: The gender distribution and age at presentation were in keeping with the literature but not the birth order. The delay before surgery emphasises the poor general health and deranged biochemical state the patients present at the hospital.

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The incidence of infantile hypertrophic pyloric stenosis and its association with folic acid supplementation during pregnancy: A nested case–control study

Cited by 18 publications

References 27 publications

Pyloric Stenosis: National Trends in the Incidence Rate and Resource Use in the United States From 2012 to 2016

Pyloric Stenosis: National Trends in the Incidence Rate and Resource Use in the United States From 2012 to 2016

The Dutch Incidence of Infantile Hypertrophic Pyloric Stenosis and the Influence of Seasons

Infantile hypertrophic pyloric stenosis: profile, management and outcome of patients admitted to a tertiary hospital in Bloemfontein, South Africa

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