Stark Christopher M, Rogers Philip L, Eberly Matthew D, Nylund Cade M
Department of Pediatrics, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, Maryland.
Pediatr Res. 2015 Aug;78(2):218-22. doi: 10.1038/pr.2015.92. Epub 2015 May 7.
Infantile hypertrophic pyloric stenosis (IHPS) has several known risk factors. The association between prematurity and IHPS and the timeline of presentation are poorly defined. Our aim was to evaluate the associations between IHPS and prematurity.
We performed a retrospective cohort study of 1,074,236 children born between June 2001 and April 2012 in the US Military Health System. IHPS cases and gestational ages (GA) were identified using billing codes. Additional risk factors for IHPS were controlled for in a multivariable logistic regression model.
The incidence of IHPS was 2.99 per 1,000 in preterm infants and 2.25 per 1,000 in full term (relative risk (RR) = 1.33, 95% confidence interval (CI) 1.16-1.54). The adjusted odds ratio for prematurity was 1.26 (95% CI 1.08-1.46). The median (interquartile range (IQR)) chronological age at presentation was 40 d (30-56) in preterm infants vs. 33 d (26-45) in full term (P < 0.001). Median postmenstrual age at presentation was 42 wk in preterm infants (40-42) vs. 45 wk (44-46) in full term (P < 0.001).
Prematurity is associated with IHPS. Premature infants develop IHPS at a later chronological age, but earlier postmenstrual age, than term infants. Providers should have an increased concern for IHPS development in premature infants.
婴儿肥厚性幽门狭窄（IHPS）有多种已知风险因素。早产与IHPS之间的关联以及发病时间尚不明确。我们的目的是评估IHPS与早产之间的关联。
我们对2001年6月至2012年4月在美国军事医疗系统出生的1,074,236名儿童进行了一项回顾性队列研究。使用计费代码确定IHPS病例和胎龄（GA）。在多变量逻辑回归模型中对IHPS的其他风险因素进行了控制。
早产儿中IHPS的发病率为每1000例中有2.99例，足月儿中为每1000例中有2.25例（相对风险（RR）=1.33，95%置信区间（CI）1.16 - 1.54）。早产的校正比值比为1.26（95%CI 1.08 - 1.46）。早产儿发病时的中位（四分位间距（IQR））实际年龄为40天（30 - 56天），而足月儿为33天（26 - 45天）（P < 0.001）。早产儿发病时的中位月经后年龄为42周（40 - 42周），而足月儿为45周（44 - 46周）（P < 0.001）。
早产与IHPS有关。与足月儿相比，早产儿在实际年龄较大时发生IHPS，但月经后年龄较早。医疗服务提供者应更加关注早产儿发生IHPS的情况。
