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DOI: 10.1055/s-0036-1593608
Inguinal Hernia Development in Very Low-Birth-Weight Infants: A Case–Control Study
Publikationsverlauf
13. Mai 2016
19. August 2016
Publikationsdatum:
18. Oktober 2016 (online)
Abstract
Introduction The incidence and risk factors for inguinal hernia (IH) is not a thoroughly evaluated issue of preterms. Prematurity is the single most important risk factor. There exists no study in our country which reported the incidence of IH in preterms. The purpose of this study is to investigate the incidence and time of diagnosis of IH in very low-birth-weight (VLBW) infants.
Patients and Methods This retrospective case–control study was conducted in Etlik Zubeyde Hanim Women's Health Training and Research Hospital and included discharged VLBW infants with gestational age less than 32 weeks. Control group included gender, birth weight, and gestational age matched VLBW infants without IH.
Results The incidence of IH was 10.1% in VLBW infants (70/693) and 16.1% in extremely low-birth-weight infants (19/174). Male/female ratio was found as 3.4:1. Most IH appeared as bilateral (40.0%). Time of diagnosis was 39 (37–42) weeks of postmenstrual age while 68.6% of infants were diagnosed after discharge. IH development increased by 2.3-folds by having respiratory distress syndrome and by 4.5 folds by achieving full enteral feeds on or after the 10th day.
Conclusion Preterms with respiratory distress syndrome and those reach full enteral feeding on or after the 10th day should be monitored carefully for IH development. Bearing in mind that a significant amount of IH cases exhibit symptoms after discharge, neonatologists should inform the parents of premature infants of the issue and close attention should be paid in postdischarge follow-up examinations.
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References
- 1 Kitchen WH, Doyle LW, Ford GW. Inguinal hernia in very low birthweight children: a continuing risk to age 8 years. J Paediatr Child Health 1991; 27 (05) 300-301
- 2 Harper RG, Garcia A, Sia C. Inguinal hernia: a common problem of premature infants weighing 1,000 grams or less at birth. Pediatrics 1975; 56 (01) 112-115
- 3 Kumar VH, Clive J, Rosenkrantz TS, Bourque MD, Hussain N. Inguinal hernia in preterm infants (< or = 32-week gestation). Pediatr Surg Int 2002; 18 (2–3): 147-152
- 4 Powell TG, Hallows JA, Cooke RW, Pharoah PO. Why do so many small infants develop an inguinal hernia?. Arch Dis Child 1986; 61 (10) 991-995
- 5 Polin RA. ; Committee on Fetus and Newborn. Management of neonates with suspected or proven early-onset bacterial sepsis. Pediatrics 2012; 129 (05) 1006-1015
- 6 Battaglia FC, Lubchenco LO. A practical classification of newborn infants by weight and gestational age. J Pediatr 1967; 71 (02) 159-163
- 7 Grosfeld JL. Current concepts in inguinal hernia in infants and children. World J Surg 1989; 13 (05) 506-515
- 8 Peevy KJ, Speed FA, Hoff CJ. Epidemiology of inguinal hernia in preterm neonates. Pediatrics 1986; 77 (02) 246-247
- 9 de Goede B, Verhelst J, van Kempen BJ. , et al. Very low birth weight is an independent risk factor for emergency surgery in premature infants with inguinal hernia. J Am Coll Surg 2015; 220 (03) 347-352
- 10 Crankson SJ, Al Tawil K, Al Namshan M. , et al. Management of inguinal hernia in premature infants: 10-year experience. J Indian Assoc Pediatr Surg 2015; 20 (01) 21-24
- 11 Burgmeier C, Dreyhaupt J, Schier F. Gender-related differences of inguinal hernia and asymptomatic patent processus vaginalis in term and preterm infants. J Pediatr Surg 2015; 50 (03) 478-480
- 12 Rajput A, Gauderer MW, Hack M. Inguinal hernias in very low birth weight infants: incidence and timing of repair. J Pediatr Surg 1992; 27 (10) 1322-1324
- 13 Pan ML, Chang WP, Lee HC. , et al. A longitudinal cohort study of incidence rates of inguinal hernia repair in 0- to 6-year-old children. J Pediatr Surg 2013; 48 (11) 2327-2331
- 14 Brooker RW, Keenan WJ. Inguinal hernia: relationship to respiratory disease in prematurity. J Pediatr Surg 2006; 41 (11) 1818-1821
- 15 Jo HS, Cho KH, Cho SI, Song ES, Kim BI. Recent changes in the incidence of bronchopulmonary dysplasia among very-low-birth-weight infants in Korea. J Korean Med Sci 2015; 30 (Suppl. 01) S81-S87
- 16 Yeo CL, Gray PH. Inguinal hernia in extremely preterm infants. J Paediatr Child Health 1994; 30 (05) 412-413
- 17 Aren A, Gökçe AH, Gökçe FS, Dursun N. Roles of matrix metalloproteinases in the etiology of inguinal hernia. Hernia 2011; 15 (06) 667-671
- 18 Smigielski J, Brocki M, Kuzdak K, Kołomecki K. Serum MMP 2 and TIMP 2 in patients with inguinal hernias. Eur J Clin Invest 2011; 41 (06) 584-588
- 19 Dik WA, van Kaam AH, Dekker T. , et al. Early increased levels of matrix metalloproteinase-9 in neonates recovering from respiratory distress syndrome. Biol Neonate 2006; 89 (01) 6-14
- 20 Prutkina EV, Sepp AV, Tsybikov NN. Enzymes of azurophilic neutrophil granules and matrix metalloproteinase-2 as markers of the developmental stages of experimental respiratory distress syndrome [in Russian]. Patol Fiziol Eksp Ter 2014; 1: 48-52
- 21 Oudesluys-Murphy AM, Teng HT, Boxma H. Spontaneous regression of clinical inguinal hernias in preterm female infants. J Pediatr Surg 2000; 35 (08) 1220-1221
- 22 Steven M, Greene O, Nelson A, Brindley N. Contralateral inguinal exploration in premature neonates: is it necessary?. Pediatr Surg Int 2010; 26 (07) 703-706
- 23 Kalantari M, Shirgir S, Ahmadi J, Zanjani A, Soltani AE. Inguinal hernia and occurrence on the other side: a prospective analysis in Iran. Hernia 2009; 13 (01) 41-43