title: The prevalence of Hirschsprung disease in premature infants after suction rectal biopsy.
abstract: BACKGROUND
  The prevalence of Hirschsprung disease (HD) in the premature infant population is not well documented. However, delayed passage of stool is common in premature infants, and suction rectal biopsy (SRB) is often used to evaluate for HD in this population. The use of SRB is unknown. Therefore, we evaluated the role of SRB in premature infants with abnormal stooling patterns.
  
  
  METHODS
  After Institutional Review Board approval, a retrospective study was conducted on all infants having an SRB performed to exclude HD from January 2000 to December 2010. Infants were divided into two groups according to gestational age (premature < 37 wk; term ≥ 37 wk). Demographics, diagnosis, treatments, and outcomes were collected. A subset analysis was performed on patients diagnosed with HD.
  
  
  RESULTS
  Two hundred sixty-nine infants were identified (113 premature and 156 term). Six premature infants (5.3%) and 79 term infants (50.6%) were found to have HD (P < 0.01). As expected, gestational age was significantly different between groups (31.7 versus 38.9 wk, P < 0.01) (Table 1). Premature infants were less likely to have prenatal care (35% versus 55%, P < 0.01) and had longer lengths of hospital stay (45.6 versus 17.6 d, P < 0.01). The most common location of aganglionosis was rectosigmoid in both groups (group 1, 50%; group 2, 33%, P = 0.7).
  
  
  CONCLUSIONS
  HD occurs significantly less often in premature infants than in term infants. Alternative diagnoses should be investigated in this population when delayed stooling patterns are encountered. SRB should be used more selectively in this group.
authors: Children's Mercy Hospital, Kansas City, Missouri, USA.
authors: Nicole E
authors: NE
authors: Sharp
authors: Janine
authors: J
authors: Pettiford-Cunningham
authors: Sohail R
authors: SR
authors: Shah
authors: Priscilla
authors: P
authors: Thomas
authors: David
authors: D
authors: Juang
authors: Shawn D
authors: SD
authors: St Peter
authors: Daniel J
authors: DJ
authors: Ostlie
mesh_terms: D017677:Age Distribution; D001706:Biopsy; D005243:Feces; D005260:Female; D005865:Gestational Age; D006627:Hirschsprung Disease / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D015995:Prevalence; D012007:Rectum; D012189:Retrospective Studies; D013396:Suction
keywords: Children; Hirschsprung disease; Neonatal; Suction rectal biopsy