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Environmental pesticides increase the risk of developing hypertrophic pyloric stenosis
Troy A Markel1, Cathy Proctor2, Jun Ying3
1Pediatric Surgery, Indiana University School of Medicine/Riley Hospital, Indianapolis, IN, United States.
Insights
Agricultural pesticide use was linked to a higher incidence of hypertrophic pyloric stenosis (HPS) in infants. This study suggests a correlation between environmental factors and this common infant condition.
Area of Science:
- Environmental Health
- Pediatric Epidemiology
- Toxicology
Background:
- Hypertrophic pyloric stenosis (HPS) is a congenital condition affecting infants, characterized by thickening of the pyloric muscle.
- The exact causes of HPS remain unclear, with suspected genetic and environmental factors.
- This study investigated a potential link between agricultural pesticide exposure and HPS incidence.
Purpose of the Study:
- To determine if agricultural pesticide use is associated with an increased incidence of hypertrophic pyloric stenosis (HPS).
- To explore correlations between pesticide types and HPS rates in specific geographic areas.
Main Methods:
- Utilized data from the Indiana Birth Defects Registry (IBDR) and live birth records (2005-2009).
- Correlated infant HPS incidence with estimated agricultural pesticide use (EPEST) data from the USGS.
- Employed univariate and multivariate logistic regression models to analyze the association.
Main Results:
- A total of 1313 HPS cases were identified among 442,329 live births, with an overall incidence of 30/10,000.
- HPS incidence showed a positive correlation with total county pesticide use, including fungicides, fumigants, insecticides, and herbicides.
- Infants in high pesticide-use counties had a higher HPS incidence (36/10,000) compared to low-use counties (26/10,000).
- The association was more pronounced in male infants born to mothers who were white, aged 20-35, had lower educational attainment, and smoked.
Conclusions:
- Significant correlation found between agricultural pesticide use and the incidence of hypertrophic pyloric stenosis.
- Pesticide exposure may be a contributing environmental factor to HPS development.
- Further research is warranted to confirm these findings and understand the mechanisms involved.
Background:
Hypertrophic pyloric stenosis (HPS) is a condition noted within the first several weeks of life that results in hypertrophy of the pyloric muscle between the stomach and duodenum. The etiology has not been elucidated but genetic and environmental influences are suspected. We hypothesized that agricultural pesticides would be associated with an increased incidence of pyloric stenosis.
Study Design:
Data from infants with HPS were obtained from the Indiana Birth Defects Registry (IBDR) for all counties in Indiana from 2005 to 2009. Data from all live births were obtained from the Indiana State Health Department (ISHD). Maternal demographics and clinical characteristics of infants were abstracted. The US Geological Survey (USGS) provided estimated use of agricultural pesticides (EPEST), and these values were correlated with HPS incidence. Univariate and multivariate logistical regression models were used to assess the association between HPS risk and pesticide use.
Results:
A total of 442,329 newborns were studied with 1313 HPS cases recorded. The incidence of HPS was 30/10,000 live births. HPS incidence was correlated with total county pesticide use, as well as subcategories of pesticides (fungicides, fumigants, insecticides, herbicides). Indiana counties were then divided into low, moderate and high pesticide use (mean±standard deviation: 127,722±73,374, 308,401±36,915, and 482,008±97,260pounds of pesticides). Incidence of HPS was 26, 29, and 36 cases per 10,000 in low, moderate and high pesticide-use counties respectively. Subset analysis showed that the positive association between HPS and county pesticide use was more likely for male infants from mothers who were white, aged 20-35 years, had education at high school or lower, and smoked (p<0.05).
Conclusion:
Pesticide use correlated significantly with incidence of HPS. Positive correlations between HPS risk and pesticide use were found for most risk factors. Further studies will be needed to verify our findings and further delineate the nature of this correlation.
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