Perinatal risk factors for infantile hypertrophic pyloric stenosis: A meta-analysis.
BACKGROUND
Infantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of nonbilious vomiting in infancy. The etiology of IHPS is not completely understood. Hence, we performed a meta-analysis to investigate the association between perinatal factors and IHPS onset.


METHODS
The MEDLINE, EMBASE, PubMed and Cochrane Library databases were searched for studies published in English before December 2016. The combined odd ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models.


RESULTS
Fifteen studies were included. Several perinatal factors, including first-born (OR 1.19, 95% CI: 1.07-1.33), cesarean section delivery (OR 1.63, 95% CI: 1.53-1.73), preterm birth (OR 1.37, 95% CI: 1.12-1.67), and bottle-feed (OR 2.46, 95% CI: 1.76-3.43), were significantly associated with the IHPS onset. Among these, bottle-feed was the most significantly risk factor for IHPS onset. Although few studies have evaluated the relationship between perinatal factors and IHPS, they have major limitations including retrospective collection of data on perinatal events and testing of multiple hypotheses without appropriate statistical corrections.


CONCLUSIONS
First-born, cesarean section delivery, preterm birth, and bottle-feed are associated with the development of IHPS. Well-designed future studies are needed to help understand the etiology of IHPS.


METHODS
Systematic reviews and meta-analyses.


METHODS
Level III.
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu 610041, China; Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Jianghu
J
Zhu
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu 610041, China; Department of Pediatrics, University of California, San Francisco, USA.
Tingting
T
Zhu
Department of Pediatrics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Zhenlang
Z
Lin
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu 610041, China; Department of Pediatrics, University of California, San Francisco, USA.
Yi
Y
Qu
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China; Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu 610041, China; Department of Pediatrics, University of California, San Francisco, USA. Electronic address: dezhi.mu@ucsf.edu.
Dezhi
D
Mu
D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010298:Parity; D036801:Parturition; D018743:Perinatal Care / Q000379:methods; D011247:Pregnancy; D047928:Premature Birth; D046248:Pyloric Stenosis, Hypertrophic / Q000209:etiology* / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors
Etiology; Infantile hypertrophic pyloric stenosis; Meta-analysis; Perinatal factor