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[Infantile hypertrophic pyloric stenosis. Decreasing incidence]
J P Nielsen1, P Haahr, J Haahr
1Viborg Sygehus, børneafdelingen. jpnielsen@dadlnet.dk
Insights
Infantile hypertrophic pyloric stenosis (IHPS) cases significantly declined in Viborg County, Denmark, from 1973 to 1997. This trend mirrored national data, with a notable decrease starting in 1993.
Area of Science:
- Pediatric Surgery
- Epidemiology
- Public Health
Context:
- A clinical suspicion of declining infantile hypertrophic pyloric stenosis (IHPS) frequency prompted this investigation.
- A 25-year retrospective review of IHPS cases in Viborg County, Denmark (1973-1997) was conducted.
- Data was supplemented by a national survey to assess broader trends.
Purpose:
- To confirm the suspected decline in IHPS incidence.
- To analyze the frequency of IHPS per 1000 live births over defined periods.
- To identify potential correlations with changes in infant care recommendations.
Summary:
- 147 IHPS cases were operated in Viborg County between 1973 and 1997.
- IHPS frequency per 1000 live births showed a declining trend, particularly after 1993 (1.6, 2.4, 2.0, 2.8, 0.9 across five-year intervals).
- A similar national trend was observed, suggesting a widespread phenomenon.
Impact:
- The study confirms a significant decrease in IHPS rates.
- A potential, though unconfirmed, association with altered infant sleep positioning recommendations is noted.
- Further research is needed to establish causality and understand the underlying reasons for the decline.
Abstract:
The aim of this study was to confirm a clinical suspicion that the frequency of this disease is in decline. A retrospective review of case notes of all children admitted and operated in all hospitals in Viborg County during the period of 1.1.1973 to 31.12.1997 was performed. The local survey was supplemented with a national survey. One hundred and forty-seven patients from Viborg County were operated for infantile hypertrophic pyloric stenosis during the period described. Divided into five year periods the number per 1000 living births was consecutively 1.6, 2.4, 2.0, 2.8 and 0.9. The same tendency was found nationally, Table 1. The decrease started in 1993 and has since strengthened. The reason is unknown, but there is a relation regarding to the timing of a change in recommendations concerning positioning of infants during sleep. However, a causal relation is unknown.