Influencing Factors Associated With Infantile Hemangioma: A Case-Control Study Among Chinese Pediatric Populations

Infantile hemangioma (IH) is the most common benign vascular tumor of infancy. While its epidemiology is well-documented in Caucasian populations, large-scale systematic studies regarding clinical characteristics and risk factors in the Chinese population remain limited. This study aims to elucidate the clinical features of IH in Chinese children and investigate risk factors associated with its development. A retrospective case-control study was conducted at the Children's Hospital of Shandong University involving children under 3 years of age treated between January and December 2024, including 1 841 children with IH (case group) and 1 894 contemporaneous non-IH patients (control group). Clinical phenotypes were analyzed, and potential risk factors were screened using univariate analysis followed by multivariate logistic regression to identify independent determinants. The cohort exhibited a female predominance (male-to-female ratio 1:1.88), with the head and neck being the most common lesion site (46.7%). Multivariate analysis identified multiple gestation (OR = 4.50, 95% CI: 3.55-5.70) as the strongest independent risk factor, followed by female gender (OR = 2.72), progestogen therapy (OR = 2.25), low birth weight (OR = 2.11), preterm birth (OR = 1.65), and pregnancy-related diseases (OR = 1.57). Notably, breastfeeding was identified as an independent protective factor against IH (OR = 0.76, 95% CI: 0.58-0.99), whereas caesarean section was not significantly associated with IH risk. This study confirms that IH pathogenesis in the Chinese population is multifactorial, strongly associated with female gender, intrauterine hypoxia (multiple gestation, pregnancy-related diseases), and perinatal hormone exposure. The protective effect of breastfeeding suggests a potential avenue for risk mitigation, and these findings provide epidemiological evidence to support early risk stratification and surveillance strategies for high-risk infants.