Inguinal hernia in preterm infants (< or = 32-week gestation)

Area of Science:

• Neonatology
• Pediatric Surgery
• Epidemiology

Background:

• The incidence of inguinal hernia (IH) in premature infants is not well-established.
• The contribution of co-morbidities like chronic lung disease (CLD) and nutritional status to IH development in preterm infants remains unclear.

Purpose of the Study:

• To determine the epidemiologic profile of preterm infants (≤32 weeks gestational age) with IH.
• To investigate whether the severity of CLD or poor nutritional status predisposes preterm infants to IH.
• To review perioperative profiles of infants undergoing IH surgery.

Main Methods:

• Retrospective study of 1,057 infants born between 23-32 weeks gestational age (GA) from 1990-1995.
• Identified risk and demographic factors, including CLD severity (days on ventilation, positive pressure, supplemental oxygen) and nutritional status (weight gain).

Main Results:

• Overall IH incidence was 9.34% in preterm infants (≤32 weeks GA) admitted for ≥28 days.
• Incidence increased in lower birth weight groups: 11.11% for ≤1,500g and 17.39% for ≤1,000g.
• Male gender (OR=9.6) and days on supplemental oxygen were significantly associated with IH; weight gain was not.

Conclusions:

• IH incidence is dependent on gestational age in premature infants.
• Severity of chronic lung disease, particularly prolonged oxygen use, is a significant predisposing factor for IH.
• Surgical correction of IH in this population is well-tolerated.