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Inguinal Hernia Development in Very Low-Birth-Weight Infants: A Case-Control Study
Sezin Unal1, Dilek Ulubas Isik1, Ahmet Yagmur Bas1
1Department of Neonatology, Etlik Zubeyde Hanım Women's Teaching and Research Hospital, Ankara, Turkey.
Insights
The incidence of inguinal hernia (IH) in very low-birth-weight (VLBW) infants is 10.1%. Respiratory distress syndrome and delayed full enteral feeds significantly increase IH risk in preterms, necessitating careful monitoring post-discharge.
Area of Science:
- Neonatalogy
- Pediatric Surgery
Background:
- Inguinal hernia (IH) is a common surgical condition in infants, but its incidence and risk factors in preterm infants, particularly those with very low birth weight (VLBW), are not well-established.
- Prematurity is a significant risk factor for IH, yet specific data from certain regions are lacking.
Purpose of the Study:
- To determine the incidence of inguinal hernia (IH) in very low-birth-weight (VLBW) infants.
- To identify the timing of IH diagnosis in this population.
- To investigate risk factors associated with IH development in VLBW infants.
Main Methods:
- A retrospective case-control study was conducted.
- Included VLBW infants (gestational age < 32 weeks) discharged from the hospital.
- Control group comprised matched VLBW infants without IH.
Main Results:
- The incidence of IH was 10.1% in VLBW infants and 16.1% in extremely low-birth-weight infants.
- The male-to-female ratio for IH was 3.4:1, and 40% of cases were bilateral.
- Diagnosis occurred at a median postmenstrual age of 39 weeks, with 68.6% diagnosed after discharge.
- Respiratory distress syndrome increased IH risk by 2.3-fold, and achieving full enteral feeds on or after day 10 increased risk by 4.5-fold.
Conclusions:
- VLBW infants with respiratory distress syndrome and those achieving full enteral feeds late require close monitoring for IH.
- A significant proportion of IH cases manifest after hospital discharge, highlighting the need for parental education and vigilant post-discharge follow-up.
Abstract:
Introduction The incidence and risk factors for inguinal hernia (IH) is not a thoroughly evaluated issue of preterms. Prematurity is the single most important risk factor. There exists no study in our country which reported the incidence of IH in preterms. The purpose of this study is to investigate the incidence and time of diagnosis of IH in very low-birth-weight (VLBW) infants. Patients and Methods This retrospective case-control study was conducted in Etlik Zubeyde Hanim Women's Health Training and Research Hospital and included discharged VLBW infants with gestational age less than 32 weeks. Control group included gender, birth weight, and gestational age matched VLBW infants without IH. Results The incidence of IH was 10.1% in VLBW infants (70/693) and 16.1% in extremely low-birth-weight infants (19/174). Male/female ratio was found as 3.4:1. Most IH appeared as bilateral (40.0%). Time of diagnosis was 39 (37-42) weeks of postmenstrual age while 68.6% of infants were diagnosed after discharge. IH development increased by 2.3-folds by having respiratory distress syndrome and by 4.5 folds by achieving full enteral feeds on or after the 10th day. Conclusion Preterms with respiratory distress syndrome and those reach full enteral feeding on or after the 10th day should be monitored carefully for IH development. Bearing in mind that a significant amount of IH cases exhibit symptoms after discharge, neonatologists should inform the parents of premature infants of the issue and close attention should be paid in postdischarge follow-up examinations.
