Journal of pediatric surgery · 2026
Some good news in a changing world? Is the incidence of pyloric stenosis decreasing?
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Chan Chun Fai, Hamid Celine, Croaker David
Аннотация
BACKGROUND: Infantile hypertrophic pyloric stenosis (IHPS) is a common cause of gastric outlet obstruction in infancy, but its incidence in the Australian Capital Territory (ACT) region has not been previously studied. This study aimed to analyse changes in IHPS incidence over thirty years and evaluate potential factors related to IHPS, including antibiotic use, proton pump inhibitor (PPI) use, and feeding methods.
METHODS: We retrospectively analysed the clinical records of IHPS patients from 1992 to 2022. A linear regression was performed to analyse the change in incidence rates. Factors such as feeding methods, antibiotic use, and PPI use were analysed using logistic regression.
RESULTS: There were 154,026 registered births in the ACT region from 1992 to 2022. A total of 327 cases of IHPS were identified, with an overall incidence rate of 2.12 per 1000 live births. Although there were some fluctuations, the incidence rate showed a decreasing trend overall, from 3.16 per 1000 live births in 1992 to 0.94 per 1000 live births in 2022. Breastfeeding was associated with a significant reduction in risk (59.5%) (p = 0.00004) of IHPS compared to formula feeding. PPI use was associated with a significant increase in risk (approximately 400%) (p = 0.032) compared to infants without PPI exposure. The associations between IHPS and other factors were not statistically significant.
CONCLUSION: Our data indicate a trend of decreasing IHPS incidence rates from 1992 to 2022. The results suggest that breastfeeding reduces the risk of developing IHPS, while PPI use is associated with the later development of IHPS.
LEVEL OF EVIDENCE: Level 3.
TYPE OF STUDY: Retrospective case control study.
METHODS: We retrospectively analysed the clinical records of IHPS patients from 1992 to 2022. A linear regression was performed to analyse the change in incidence rates. Factors such as feeding methods, antibiotic use, and PPI use were analysed using logistic regression.
RESULTS: There were 154,026 registered births in the ACT region from 1992 to 2022. A total of 327 cases of IHPS were identified, with an overall incidence rate of 2.12 per 1000 live births. Although there were some fluctuations, the incidence rate showed a decreasing trend overall, from 3.16 per 1000 live births in 1992 to 0.94 per 1000 live births in 2022. Breastfeeding was associated with a significant reduction in risk (59.5%) (p = 0.00004) of IHPS compared to formula feeding. PPI use was associated with a significant increase in risk (approximately 400%) (p = 0.032) compared to infants without PPI exposure. The associations between IHPS and other factors were not statistically significant.
CONCLUSION: Our data indicate a trend of decreasing IHPS incidence rates from 1992 to 2022. The results suggest that breastfeeding reduces the risk of developing IHPS, while PPI use is associated with the later development of IHPS.
LEVEL OF EVIDENCE: Level 3.
TYPE OF STUDY: Retrospective case control study.