Background and Objective The etiology and exact incidence of infantile hemangiomas (IH) are unknown. Prior studies have noted immunohistochemical and biologic characteristics shared by IH and placental tissue. We investigated the possible association between placental anomalies and the development of IH, as well as the demographic characteristics and other risk factors for IH. Methods 578 pregnant women were prospectively enrolled and their offspring followed for 9 months. Placental evaluations were performed and demographic data collected on all mother-infant pairs. Results 594 infants were evaluated: 32 hemangiomas (either IH or congenital (CH)) were identified in 27 infants, yielding an incidence of 4.5% for IH and 0.3% for CH. Placental anomalies were noted in almost 35% of hemangioma-related pregnancies, approximately twice the incidence noted in pregnancies with unaffected infants. (p = 0.025). Other risk factors for IH included prematurity (p = 0.016) and low birth weight (p = 0.028). All IH were present by 3 months of age, and cessation of growth had occurred in all by 9 months of age. Most occurred on the trunk. Of note, 20% of identified IH were abortive/telangiectatic in nature, small focal lesions that did not proliferate beyond 3 months of age. Only one IH required intervention. Conclusions This is the first prospective American study to document the incidence of IH in infants followed from birth to early infancy. The association with placental anomalies was statistically significant. The overall incidence mirrors prior estimates, but the need for treatment was lower than previously reported.

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