December 6, 2023
2 minute read
Important points:
- Preterm birth was significantly associated with the onset of appendicitis before the age of 1 year.
- Diagnosis requires consideration of history of preterm birth.
Preterm infants have an increased risk of developing appendicitis during their first year of life, according to a study published today. Pediatrics.
“Given the low frequency of acute appendicitis in infants and the atypical presentation of acute appendicitis in nonverbal patients, delays in diagnosis and treatment are almost certain.” Yakun Dr. Liu, and colleagues from the Department of General Surgery, Dongzhou University Children’s Hospital in Suzhou, Jiangsu Province, China.
“Historically, bacterial invasive infection was thought to be an important factor in the development and progression of appendicitis,” the researchers continued. “It has been hypothesized that preterm infants may be at higher risk for appendicitis due to their immature immune system and increased susceptibility to infections. However, there is a potential link between preterm birth and infant appendicitis. The relationship has not yet been investigated.”
This retrospective, multicenter case-control study included 106 infants diagnosed with appendicitis (median age 2.4 months, 68.9% boys, 34% history of preterm delivery) and 1,060 healthy controls (median age 2.5 months). , investigated this association. month, 54.6% boys, history of preterm birth, 11.6%). Infants from three children’s hospitals and tertiary care centers were grouped by age: neonates 0 days to 28 days old and older infants >28 days old but less than 1 year old.
Using univariate analysis, researchers found that preterm birth was significantly associated with the onset of appendicitis before the age of 1 year (OR = 4.23; 95% CI, 2.67-6.7). Other factors associated with increased risk of infantile appendicitis include male gender (OR = 1.91; 95% CI, 1.25-2.94) and weight-for-age. z score (OR = 0.72; 95% CI, 0.64-0.81) and fed exclusively with formula (OR = 2.95; 95% CI, 1.77-4.91).
Multivariate analysis still showed a significant association between preterm birth and appendicitis (adjusted OR = 3.32; 95% CI, 1.76-6.24), which was similar in subgroup analyzes for both neonates (aOR = 4.56; 95% CI, 2.14-9.71). and older infants (aOR = 3.63; 95% CI, 1.72-7.65).
The researchers also found that 72.6% of the appendicitis group presented with perforated appendicitis, but a history of preterm birth was not associated with the incidence of perforation (OR = 0.79; 95% CI, 0.32-1.91) .
“Preterm infants are at increased risk of appendicitis during the first year of life,” Liu et al. write. “Diagnostic algorithms for infantile appendicitis should consider history of preterm birth. Future studies are warranted to expand knowledge about infantile appendicitis and facilitate timely diagnosis.”
