The Dutch Incidence of Infantile Hypertrophic Pyloric Stenosis and the Influence of Seasons

Abstract

Introduction Studies report contradicting results on the incidence of infantile hypertrophic pyloric stenosis (IHPS) and its association with seasons. We aim to assess the IHPS incidence in the Netherlands and to determine whether seasonal variation is present in a nationwide cohort. Materials and Methods All infants with IHPS hospitalized in the Netherlands between 2007 and 2017 were included in this retrospective cohort study. Incidence rates per 1,000 livebirths (LB) were calculated using total number of LB during the matched month, season, or year, respectively. Seasonal variation based on month of birth and month of surgery was analyzed using linear mixed model and one-way ANOVA, respectively. Results A total of 2,479 infants were included, of which the majority was male (75.9%). Median (interquartile range) age at surgery was 34 (18) days. The average IHPS incidence rate was 1.28 per 1,000 LB (variation: 1.09–1.47 per 1,000 LB). We did not find a conclusive trend over time in IHPS incidence. Differences in incidence between season of birth and season of surgery were not significant (p = 0.677 and p = 0.206, respectively). Conclusion We found an average IHPS incidence of 1.28 per 1,000 LB in the Netherlands. Our results showed no changing trend in incidence and no seasonal variation.

The Safety and Effectiveness of Laparoscopic Pyloromyotomy Using 3-mm Electrocautery Hook versus Open Surgery for Treatment of Hypertrophic Pyloric Stenosis in Infants

“…It is four times more common in male than female newborns. It is most commonly seen in white population, while it is rare in Black and Asian populations [1,4].…”

“…At birth newborns are well and usually tolerate meals properly for the first two weeks. This condition, in most of the cases, occurs between the third and sixth week of life [1,4]. In very rare cases late onset presentation of hypertrophic pyloric stenosis has been described, with age ranging from three months to five years of age [5].…”

“…In the beginning, infants occasionally vomit after the meal. However, as the disease progresses the infants present with typical clinical appearance of hypertrophic pyloric stenosis, projectile vomiting after every meal, which if left untreated may potentially lead to dehydration, electrolyte imbalance, and weight loss [1][2][3][4]6]. In a certain percentage of infants, a hard, non-tender pylorus (so-called olive) may be palpated near the epigastrium.…”