Early developmental outcome of infants with infantile hypertrophic pyloric stenosis.
OBJECTIVE
The study aimed to compare the developmental outcome of infants with infantile hypertrophic pyloric stenosis (IHPS) who underwent pyloromyotomy with healthy control infants in New South Wales (NSW), Australia.


METHODS
Infants diagnosed with IHPS requiring surgical intervention were enrolled prospectively between August 1, 2006, and July 31, 2008. Healthy control infants were enrolled in the same period. The children underwent a developmental assessment at 1 year of age (corrected) using the Bayley Scales of Infant and Toddler Development (Version III).


RESULTS
Of 52 infants with IHPS who were enrolled, 43 had developmental assessments. Most (90.6%) were term infants (>36 weeks gestation) with a median birth weight of 3237.8 g. Two infants (8%) had an associated birth defect, and survival was 100%. Developmental assessments were also performed on 211 control infants. Infants with IHPS scored significantly lower on the cognitive, receptive language, fine motor, and gross motor subscales compared to the control infants.


CONCLUSIONS
This unique study found lower than expected developmental scores for infants after surgery for IHPS than for healthy control infants. These findings raise concerns over the potential impact of IHPS and its surgical treatment. Further studies, including continuing developmental review to determine whether these differences persist and their functional importance, should be performed.
Grace Centre for Newborn Care, The Children's Hospital at Westmead, Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, New South Wales 2145, Australia. karenw4@chw.edu.au
Karen
K
Walker
Robert
R
Halliday
Andrew J A
AJ
Holland
Caroline
C
Karskens
Nadia
N
Badawi
D015897:Comorbidity; D002658:Developmental Disabilities / Q000453:epidemiology* / Q000209:etiology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007805:Language Development Disorders / Q000453:epidemiology* / Q000209:etiology; D019957:Motor Skills Disorders / Q000453:epidemiology* / Q000209:etiology; D009517:New South Wales / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D046248:Pyloric Stenosis, Hypertrophic / Q000453:epidemiology* / Q000523:psychology / Q000601:surgery; D018401:Sample Size; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires