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Trends in infantile hypertrophic pyloric stenosis in Olmsted County, Minnesota, 1950-1984
M B Jedd1, L J Melton, M R Griffin
1Mayo Medical School, Mayo Clinic, Rochester, Minnesota 55905.
Insights
Infantile hypertrophic pyloric stenosis (IHPS) incidence rose significantly in males but not females from 1950-1984. This suggests differing etiological factors for IHPS in male and female infants.
Area of Science:
- Pediatric Gastroenterology
- Epidemiology
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) is a congenital anomaly affecting the pylorus.
- Understanding IHPS incidence trends is crucial for etiological research.
Observation:
- A 35-year study (1950-1984) in Olmsted County, Minnesota, identified 154 infants with IHPS.
- Complete ascertainment was achieved through comprehensive medical record review.
Findings:
- Overall IHPS incidence was 2.6 per 1000 person-years, with a male:female ratio of 4.1:1.
- A notable increase in IHPS incidence occurred in male infants over the study period.
- Incidence rates for females remained stable, highlighting a sex-specific trend.
Implications:
- The divergent incidence trends in male and female infants suggest distinct etiological pathways.
- Future research should explore factors contributing to the rising IHPS rates in males.
- These findings necessitate the development of sex-specific hypotheses for IHPS etiology.
Abstract:
In the 35-year period, 1950-1984, 154 Olmsted County, Minnesota, infants were diagnosed with definite infantile hypertrophic pyloric stenosis (IHPS). Patients were identified using outpatient and inpatient records of all providers of care to the circumscribed population, and ascertainment was complete insofar as diagnosed cases are concerned. The overall incidence of IHPS was 2.6 per 1000 person-years (95% confidence interval: 2.2-3.0), with a male:female ratio of 4.1:1. A dramatic rise in incidence was seen among male infants over the study period, but not for females, so that by 1980-1984 the rates for the two sexes were 6.2 and 0.9 per 1000 person-years, respectively. Improvements in diagnostic capabilities and case identification may have occurred but seem unlikely to entirely account for these changes. Aetiologic hypotheses should reflect the different trends for male and female infants.