The Relationship Between Prematurity and Hypertrophic Pyloric Stenosis

Toribio Hanako-Tanaka, William Robert Zafra-Alegre, Christian Zafra-Saldaña, Carlos Zavaleta-Corvera, Jose Caballero-Alvarado, Hugo Rodriguez-Milla

Abstract

Background: Hypertrophic pyloric stenosis (HPS) is defined as a malformation of the digestive tract that is produced by continuous hypertrophy of the pyloric sphincter. HPS is a condition that requires surgical intervention. There has been a significant rise in the incidence of this condition, and it continues to be a challenge for the pediatric and general surgeons to treat.

Aim: To determine if prematurity is a risk factor of HPS

Materials and Methods: This was an observational, analytical, retrospective, case–control study. The samples were collected by reviewing medical records. A total of 165 patients were considered for the study, of which 55 patients presented a diagnosis of HPS (case group), and 110 patients did not have HPS (control group). Data about the gestational age at birth, neonatal sex, first-born status, maternal age, maternal smoking status, and use of breast milk substitutes were collected. The association of each of these variables with the incidence of HPS was statistically analyzed.

Results: It was observed that 40% of the patients with HPS were born premature, and only 15.5% of the patients without HPS were born premature. Hence, there was a higher proportion of prematurity in cases than controls (OR = 3.64, P < .01), indicating that prematurity increased the risk of HPS by 3.64 times. The association of the male sex (OR = 4.00, P = .000), first born (OR = 2.53, P = .006), and the use of breast milk substitutes (OR: 5.31; P = .000) with the incidence of HPS was found to be statistically significant.

Conclusion: Prematurity was found to significantly increase the risk of HPS, with premature neonates being 3.64 times more likely to present with HPS than those born at term. Additionally, the male sex, first-born status, and the use of breast milk substitutes were found to be associated with an increased risk of HPS.