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Birth Defects Res. 2019 Feb 1;111(3):159-169. doi: 10.1002/bdr2.1439. Epub 2018 Dec 13.

Prevalence and descriptive epidemiology of infantile hypertrophic pyloric stenosis in the United States: A multistate, population-based retrospective study, 1999-2010.

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Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa.
Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, Iowa.
Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas.
Department of Epidemiology and Biostatistics, University of Albany School of Public Health, State University of New York, New York, New York.
Department of Community and Family Health, College of Public Health, University of South Florida, Florida.
Birth Defects Monitoring Program, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina.
Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.



Antecedents for infantile hypertrophic pyloric stenosis (IHPS) vary across studies; therefore, we conducted a multistate, population-based retrospective study of the prevalence and descriptive epidemiology of IHPS in the United States (US).


Data for IHPS cases (n = 29,554) delivered from 1999-2010 and enumerated from 11 US population-based birth defect surveillance programs, along with data for live births (n = 14,707,418) delivered within the same birth period and jurisdictions, were analyzed using Poisson regression to estimate IHPS prevalence per 10,000 live births. Additional data on deliveries from 1999-2005 from seven of these programs were analyzed using multivariable logistic regression to estimate adjusted prevalence ratios (aPR)s and 95% confidence intervals (CI)s for selected infant and parental characteristics.


Overall, IHPS prevalence from 1999-2010 was 20.09 (95% CI = 19.87, 20.32) per 10,000 live births, with statistically significant increases from 2003-2006 and decreases from 2007-2010. Compared to their respective referents, aPRs were higher in magnitude for males, preterm births, and multiple births, but lower for birth weights <2,500 g. The aPRs for all cases increased with decreasing parental age, maternal education, and maternal parity, but decreased for parental race/ethnicity other than non-Hispanic White. Estimates restricted to isolated cases or stratified by infant sex were similar to those for all cases.


This study covers one of the largest samples and longest temporal period examined for IHPS in the US. Similar to findings reported in Europe, estimates suggest that IHPS prevalence has decreased recently in the US. Additional analyses supported associations with several infant and parental characteristics.


descriptive; epidemiology; infantile hypertrophic pyloric stenosis; population-based; prevalence


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