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Inguinal hernia in very low birthweight children: a continuing risk to age 8 years
W H Kitchen1, L W Doyle, G W Ford
1Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.
Insights
Very low birthweight boys are at high risk for inguinal hernias, requiring surgery even up to age 8. This condition is significantly more common in boys than girls, with many cases developing after infancy.
Area of Science:
- Pediatric Surgery
- Neonatology
- Public Health
Background:
- Inguinal hernias are a common surgical condition in infants.
- Premature infants, especially those with very low birthweight, may have increased risks for certain medical conditions.
- Long-term follow-up is crucial for understanding the full impact of prematurity on health outcomes.
Purpose of the Study:
- To determine the prevalence of inguinal hernia repair in children born with very low birthweight (VLBW) up to 8 years of age.
- To identify risk factors associated with inguinal hernia development in this population.
- To analyze the timing of inguinal hernia occurrence and surgical intervention.
Main Methods:
- A cohort study of 205 inborn children with birthweight less than 1500 grams who survived to 8 years of age.
- Data collection included surgical records for inguinal hernia repair.
- Statistical analysis was performed to compare prevalence between genders and identify risk factors.
Main Results:
- Overall, 18.0% of children required inguinal hernia surgery by age 8.
- Boys had a significantly higher prevalence (32.0%) compared to girls (3.9%).
- In boys, 36.4% of hernias occurred after 2 years of age, with cumulative surgery rates reaching 32.0% by age 8. Risk was marginally higher for those requiring assisted ventilation or with birthweight <1000g.
Conclusions:
- Very low birthweight infants, particularly boys, face a prolonged risk of inguinal hernia development extending beyond infancy to at least 8 years of age.
- The high cumulative incidence in boys underscores the need for continued monitoring.
- These findings highlight the importance of long-term pediatric surgical surveillance for VLBW survivors.
Abstract:
The prevalence of inguinal hernia repair up to 8 years of age was determined in 205 inborn children of birthweight less than 1500 g who had survived to the age of 8 years; 37 (18.0%) of the children required surgery for inguinal hernia, significantly more frequently for boys than girls (32.0% and 3.9% respectively). The cumulative percentage of inguinal hernia operations in boys was 8.7% during primary hospitalization, 20.4% by 2 years, 30.1% by 5 years and 32.0% by 8 years; 36.4% (12 of 33) hernias in boys occurred beyond 2 years of age. The risk of hernia in boys was only marginally higher in those who required assisted ventilation and in those of birthweight less than 1000 g. Very low birthweight infants, particularly boys, are at risk of developing an inguinal hernia not only in infancy but also to at least 8 years of age.