Seasonal and feeding variations in the development of pyloric stenosis: A retrospective case-control study

To examine the association between pyloric stenosis development and seasonal variation or feeding practices.

Ethical approval was obtained. A retrospective chart review was conducted for patients treated for pyloric stenosis at our centre in central Canada between January 1st, 2012 and December 31st, 2022. Sex and age-matched controls were identified as patients admitted within two months of age with pneumonia, inguinal hernia, or orthopedic conditions. Cases and controls were also matched by season of hospital admission. Descriptive statistics and regression analyses were conducted using Microsoft Excel and R.

A total of 296 pyloric stenosis cases and 296 controls were reviewed. Using Poisson regression, the effect of season on pyloric stenosis rates was evaluated while adjusting for year. A statistically significant association between season and PS incidence (p = 0.007) was found. Compared to the winter, pyloric stenosis rates were 1.33 times higher in the fall (95 % CI: 0.93-1.92), 1.41 times higher in the spring (95 % CI: 0.99-2.02), and 1.80 times higher in the summer (95 % CI: 1.29-2.54). Additionally, when controlling for age, sex, and season, there was a significant association between feeding practices and pyloric stenosis development (p < 0.001). Formula-fed infants were 3.7 times more likely to be diagnosed with pyloric stenosis compared to breast milk fed infants, while those fed both breast milk and formula had 1.7 times the odds of diagnosis.

Pyloric stenosis incidence shows significant seasonal variation and feeding practice associations, suggesting potential modifiable risk factors in its development.

III.

Retrospective Case-Control Study.