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Prematurity Affects Age of Presentation of Pyloric Stenosis

Caitlyn M Costanzo1,2, Charles Vinocur1,2, Loren Berman1,2

  • 11 Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE, USA.

Clinical Pediatrics
|May 7, 2016
PubMed

Insights

Premature infants with hypertrophic pyloric stenosis (HPS) present later, with greater prematurity linked to older age at diagnosis. This prematurity also increases surgical risks and recovery time.

Area of Science:

  • Pediatric Surgery
  • Neonatology
  • Gastroenterology

Background:

  • Hypertrophic pyloric stenosis (HPS) diagnosis typically occurs at 4-6 weeks in term infants.
  • Limited consensus exists regarding the presentation age of HPS in premature infants.
  • Understanding prematurity's impact on HPS presentation is crucial for timely diagnosis and management.

Purpose of the Study:

  • To investigate the association between the degree of prematurity and the chronological age of HPS presentation.
  • To identify specific postconceptional age ranges for considering HPS in premature infants.
  • To inform clinical evaluation and family counseling regarding HPS in premature populations.

Main Methods:

  • Retrospective analysis of 2988 infants undergoing pyloromyotomy for HPS from NSQIP-P database (2012-2013).
  • Categorization of infants into term and premature groups (n=217).
  • Statistical analysis to determine the correlation between prematurity and age of presentation, and associated morbidities.

Main Results:

  • Greater prematurity was significantly associated with an older chronological age at HPS presentation (P < .0001).
  • Prematurity correlated with increased overall postoperative morbidity, reintubation, readmission, and longer hospital stays.
  • A postconceptional age of 44-50 weeks should prompt consideration of HPS in premature infants presenting with nonbilious emesis.

Conclusions:

  • Clinicians should consider HPS in premature infants with nonbilious emesis, particularly within a postconceptional age of 44-50 weeks.
  • Surgeons must counsel families of premature infants about the heightened risk of post-pyloromyotomy complications.
  • The degree of prematurity influences HPS presentation age and surgical outcomes, necessitating tailored clinical approaches.

Keywords:
hypertrophic pyloric stenosispostoperative outcomeprematuritypyloromyotomy

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