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Perinatal risk factors for infantile hypertrophic pyloric stenosis: A meta-analysis
Jianghu Zhu1, Tingting Zhu2, Zhenlang Lin3
1Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu 610041, China; Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Insights
Infantile hypertrophic pyloric stenosis (IHPS) is linked to being first-born, cesarean delivery, preterm birth, and bottle-feeding. Bottle-feeding emerged as the most significant risk factor for IHPS onset.
Area of Science:
- Pediatric Surgery
- Neonatal Research
- Epidemiology
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) is a leading surgical cause of nonbilious vomiting in infants.
- The precise etiology of IHPS remains incompletely understood.
- Investigating perinatal factors is crucial for understanding IHPS development.
Purpose of the Study:
- To conduct a meta-analysis examining the association between various perinatal factors and the onset of IHPS.
- To identify significant risk factors contributing to IHPS development in infants.
Main Methods:
- Systematic review and meta-analysis of published studies.
- Searched MEDLINE, EMBASE, PubMed, and Cochrane Library databases (pre-December 2016).
- Calculated combined odds ratios (ORs) and 95% confidence intervals (CIs) using random-effects models.
Main Results:
- Fifteen studies met inclusion criteria.
- Significant associations found between IHPS and first-born status (OR 1.19), cesarean delivery (OR 1.63), preterm birth (OR 1.37), and bottle-feeding (OR 2.46).
- Bottle-feeding demonstrated the strongest association with IHPS onset.
Conclusions:
- Perinatal factors including first-born status, cesarean delivery, preterm birth, and bottle-feeding are associated with IHPS.
- Bottle-feeding is a significant risk factor for IHPS.
- Further well-designed studies are required to elucidate the etiology of IHPS.
Background:
Infantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of nonbilious vomiting in infancy. The etiology of IHPS is not completely understood. Hence, we performed a meta-analysis to investigate the association between perinatal factors and IHPS onset.
Methods:
The MEDLINE, EMBASE, PubMed and Cochrane Library databases were searched for studies published in English before December 2016. The combined odd ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models.
Results:
Fifteen studies were included. Several perinatal factors, including first-born (OR 1.19, 95% CI: 1.07-1.33), cesarean section delivery (OR 1.63, 95% CI: 1.53-1.73), preterm birth (OR 1.37, 95% CI: 1.12-1.67), and bottle-feed (OR 2.46, 95% CI: 1.76-3.43), were significantly associated with the IHPS onset. Among these, bottle-feed was the most significantly risk factor for IHPS onset. Although few studies have evaluated the relationship between perinatal factors and IHPS, they have major limitations including retrospective collection of data on perinatal events and testing of multiple hypotheses without appropriate statistical corrections.
Conclusions:
First-born, cesarean section delivery, preterm birth, and bottle-feed are associated with the development of IHPS. Well-designed future studies are needed to help understand the etiology of IHPS.
Type Of Study:
Systematic reviews and meta-analyses.
Level Of Evidence:
Level III.
