title: Risk factors and morbidity of infantile haemangioma: preterm birth promotes ulceration.
abstract: OBJECTIVE
  We identified the characteristics of an infantile haemangioma (IH) that predispose children to complications, interventions and long-term morbidity and examined perinatal risk factors for IH.
  
  
  METHODS
  We studied children with IHs admitted to Helsinki University Hospital's paediatric vascular anomaly clinic in Finland in 2004-2007 and registered perinatal records, IH characteristics, complications and interventions. These patients received a questionnaire on perinatal data and long-term morbidity resulting from IH. We analysed factors related to complications, interventions and morbidity and compared our cohort's perinatal data to the Finnish Medical Birth Register (FMBR) figures.
  
  
  RESULTS
  We approached 185 families, of which 136 replied to the questionnaire. Children with facial, segmental and indeterminate IHs showed more complications, interventions and higher long-term morbidity. Preterm birth predisposed infants to ulceration of IHs, with a 95% confidence interval (CI) of 1.02-5.14 and odds ratio (OR) of 2.29. In addition to earlier known risks, maternal gestational diabetes mellitus rate was higher in our IH cohort than the rate in the FMBR (95% CI 1.39-4.95, OR 2.62).
  
  
  CONCLUSIONS
  Physicians treating IHs should consider the elevated ulceration risk in preterm infants. The association between gestational diabetes mellitus and child's risk for an IH is uncertain and requires further research.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Eeva
authors.initials: E
authors.lastname: Castrén
authors.affiliation: Department of Paediatric Surgery, Children's and Adolescent's Hospital, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Päivi
authors.initials: P
authors.lastname: Salminen
authors.affiliation: Information Services Department, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
authors.affiliation: Department of Obstetrics and Gynecology, Fetomaternal Medical Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Vedran
authors.initials: V
authors.lastname: Stefanovic
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Anne
authors.initials: A
authors.lastname: Pitkäranta
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Klockars
mesh_terms: D016640:Diabetes, Gestational; D005260:Female; D006391:Hemangioma / Q000150:complications / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D012307:Risk Factors
keywords: Gestational diabetes mellitus; Infantile haemangioma; Preterm; Vascular anomalies; Vascular tumour