Perinatal risk factors for infantile hypertrophic pyloric stenosis: A meta-analysis

Jianghu Zhu; Tingting Zhu; Zhenlang Lin; Yi Qu; Dezhi Mu

doi:10.1016/j.jpedsurg.2017.02.017

Perinatal risk factors for infantile hypertrophic pyloric stenosis: A meta-analysis

J Pediatr Surg. 2017 Sep;52(9):1389-1397. doi: 10.1016/j.jpedsurg.2017.02.017. Epub 2017 Mar 15.

Authors

Jianghu Zhu¹, Tingting Zhu², Zhenlang Lin³, Yi Qu², Dezhi Mu⁴

Affiliations

¹ Department 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.
² Department 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, University of California, San Francisco, USA.
³ Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
⁴ Department 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, University of California, San Francisco, USA. Electronic address: dezhi.mu@ucsf.edu.

PMID: 28318599
DOI: 10.1016/j.jpedsurg.2017.02.017

Abstract

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.

Keywords: Etiology; Infantile hypertrophic pyloric stenosis; Meta-analysis; Perinatal factor.

Publication types

Meta-Analysis
Review

MeSH terms

Cesarean Section / adverse effects
Female
Humans
Infant
Infant, Newborn
Male
Parity
Parturition
Perinatal Care / methods
Pregnancy
Premature Birth
Pyloric Stenosis, Hypertrophic / etiology*
Pyloric Stenosis, Hypertrophic / prevention & control*
Retrospective Studies
Risk Factors