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Environmental exposure in the etiology of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis

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Abstract

Purpose

To investigate the occupational and environmental factors in the etiology of infantile hypertrophic pyloric stenosis (IHPS).

Methods

Protocol was drafted according to the PRISMA guidelines and registered on PROSPERO (CRD42020152460). A search for a combination of terms related to IHPS, fetus and neonates, and environmental exposure was performed for studies published between 2000 and 2020 in the EMBASE, Pubmed, and MEDLINE databases.

Results

Overall, 2203 abstracts were identified and 829 were screened. The full text of the selected articles (N = 98) was assessed for eligibility. Fifteen studies were included in quantitative synthesis. IHPS risk was significantly lower in black and Hispanic mothers than in white mothers [OR 0.47 (95% CI 0.44–0.51, p < 0.001), OR 0.85 (95% CI 0.77–0.94, p = 0.002), respectively]. Lower maternal education level and maternal smoking were risk factor for IHPS. We further observed a non-significant association between maternal folic acid usage and IHPS risk. Data were insufficient to evaluate occupational exposure.

Conclusion

This review provides an understanding of the role of environmental exposures in IHPS etiology. Lower maternal educational level, maternal smoking, and white ethnicity are associated with a significantly increased risk of IHPS, while folic acid use seems non-significantly associated with IHPS risk.

Level of evidence

III.

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Acknowledgements

The study protocol was registered on PROSPERO (Registration Number: CRD42020152460). The manuscript was edited by Hacettepe Technopolis Technology Transfer Center (HT-TTM).

Funding

The study is supported by Hacettepe University, Scientific Research Council (Grant Number: 18121).

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Ozlem Boybeyi-Turer, Tutku Soyer & Feridun Cahit Tanyel

  2. Department of Pediatrics, Division of Neonatology, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Hasan Tolga Celik

  3. Department of Health Research, Hacettepe University Institute of Public Health, Ankara, Turkey

    Umut Ece Arslan

  4. Department of Occupational Health and Safety, Hacettepe University Institute of Public Health, Ankara, Turkey

    Sibel Kiran

Authors
  1. Ozlem Boybeyi-Turer
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  2. Hasan Tolga Celik
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  3. Umut Ece Arslan
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  4. Tutku Soyer
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  5. Feridun Cahit Tanyel
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  6. Sibel Kiran
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Contributions

The authors contributed to the study as following: (i) conception and design: all authors, (ii) materials, investigations and literature search: B-TO, CHT, ST, and AUE, (iii) analysis and interpretation: AUE, B-TO, and ST, (iv) writer and supervision: B-TO, KS, and CHT, and (v) critical review: ST, TFC, and KS.

Corresponding author

Correspondence to Ozlem Boybeyi-Turer.

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Conflict of interest

All authors declare that there is no conflict of interest.

Ethical considerations

Formal ethical approval is not required for this study. An institutional collaboration is approved by the Local Ethical Committee (11/12/2018-2230) revealing that this study does not need an ethical approval.

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Feridun Cahit Tanyel: Member of Turkey Academy of Sciences, Ankara, Turkey.

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Boybeyi-Turer, O., Celik, H.T., Arslan, U.E. et al. Environmental exposure in the etiology of infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis. Pediatr Surg Int 38, 951–961 (2022). https://doi.org/10.1007/s00383-022-05128-9

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  • DOI: https://doi.org/10.1007/s00383-022-05128-9

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