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Early developmental outcome of infants with infantile hypertrophic pyloric stenosis
Karen Walker1, Robert Halliday, Andrew J A Holland
1Grace Centre for Newborn Care, The Children's Hospital at Westmead, Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, New South Wales 2145, Australia. karenw4@chw.edu.au
Insights
Infants with infantile hypertrophic pyloric stenosis (IHPS) who underwent surgery showed lower developmental scores than healthy peers. This suggests potential impacts of IHPS and its treatment on infant development.
Area of Science:
- Pediatric surgery
- Developmental pediatrics
- Neonatal care
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) is a common surgical condition in infants.
- Pyloromyotomy is the standard surgical treatment for IHPS.
- Long-term developmental outcomes following IHPS surgery require further investigation.
Purpose of the Study:
- To compare the 1-year developmental outcomes of infants treated for IHPS with healthy controls.
- To assess cognitive, language, and motor development in infants with a history of IHPS.
- To identify potential long-term effects of IHPS and its surgical management on infant development.
Main Methods:
- Prospective enrollment of infants with IHPS and healthy controls in New South Wales.
- Developmental assessment at 1 year corrected age using Bayley Scales of Infant and Toddler Development (III).
- Comparison of developmental scores between IHPS and control groups.
Main Results:
- Infants with IHPS (n=43) showed significantly lower scores in cognitive, receptive language, fine motor, and gross motor domains compared to controls (n=211).
- Most IHPS infants were term (90.6%) with a median birth weight of 3237.8g.
- Survival rate was 100% with 8% having associated birth defects.
Conclusions:
- Infants undergoing surgery for IHPS demonstrated lower developmental scores than healthy controls at one year.
- These findings highlight potential concerns regarding the impact of IHPS and its surgical treatment on infant development.
- Further longitudinal studies are recommended to determine the persistence and functional significance of these developmental differences.
Purpose:
The study aimed to compare the developmental outcome of infants with infantile hypertrophic pyloric stenosis (IHPS) who underwent pyloromyotomy with healthy control infants in New South Wales (NSW), Australia.
Methods:
Infants diagnosed with IHPS requiring surgical intervention were enrolled prospectively between August 1, 2006, and July 31, 2008. Healthy control infants were enrolled in the same period. The children underwent a developmental assessment at 1 year of age (corrected) using the Bayley Scales of Infant and Toddler Development (Version III).
Results:
Of 52 infants with IHPS who were enrolled, 43 had developmental assessments. Most (90.6%) were term infants (>36 weeks gestation) with a median birth weight of 3237.8 g. Two infants (8%) had an associated birth defect, and survival was 100%. Developmental assessments were also performed on 211 control infants. Infants with IHPS scored significantly lower on the cognitive, receptive language, fine motor, and gross motor subscales compared to the control infants.
Conclusions:
This unique study found lower than expected developmental scores for infants after surgery for IHPS than for healthy control infants. These findings raise concerns over the potential impact of IHPS and its surgical treatment. Further studies, including continuing developmental review to determine whether these differences persist and their functional importance, should be performed.
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