Infantile Appendicitis: Insights into a Rare but Serious Condition

Research Article| March 01 2024 Infantile Appendicitis: Insights into a Rare but Serious Condition AAP Grand Rounds (2024) 51 (3): 34. https://doi.org/10.1542/gr.51-3-34 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Infantile Appendicitis: Insights into a Rare but Serious Condition. AAP Grand Rounds March 2024; 51 (3): 34. https://doi.org/10.1542/gr.51-3-34 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: appendicitis Source: Liu Y, Yu X, Zhang PG, et al. Preterm birth and infantile appendicitis. Pediatrics. 2023;152(6):e2023063815; doi: https://doi.org/10.1542/peds.2023-063815.Google Scholar Investigators from multiple institutions in China conducted a case-control study to assess the association between preterm birth and appendicitis in the first year of life. For the study, they searched databases of 3 children's hospitals and 1 tertiary medical center to identify patients <1 year old admitted between 2007 and 2023 with a diagnosis of pathology-confirmed appendicitis. For each case with appendicitis, 10 age-matched healthy controls without a diagnosis of appendicitis were chosen using data on patients <1 year seen in the outpatient primary care department. The medical records of study infants were reviewed, and demographic data, birth history, infant feeding method (breast, formula, or both), and weight measurements (converted to weight-adjusted z-scores [WAZ]) were abstracted. Premature birth was defined as birth prior to 37 weeks' gestation. Characteristics in cases and controls were compared with univariate analyses, and variables with a significant association with appendicitis were included in multivariate regression models. The primary analysis was to determine the independent association between preterm birth and appendicitis. Secondary analyses included the association between preterm birth and appendicitis in neonates (<28 days old), appendicitis in older infants, and the association between appendiceal perforation and preterm birth. Regression analysis also was used to assess whether preterm birth was associated with appendiceal perforation among patients with appendicitis. A total of 106 infants with appendicitis occurring in the first year of life were identified and matched with 1,060 controls. The median age of cases and controls was 2.4 months. Among cases with appendicitis, 36 (34%) had a history of preterm birth compared to 123 (11.6%) of controls (P <0.001 in univariate analysis). In the multivariate model, preterm birth was independently associated with appendicitis (aOR, 3.32; 95% CI, 1.76, 6.24). Other variables associated with appendicitis included male sex (aOR, 3.10; 95% CI, 1.85, 5.19), formula feeding (aOR, 1.80; 95% CI, 1.01, 3.20), and WAZ (aOR, 0.44; 95% CI, 0.23, 0.83). Preterm birth was significantly associated with appendicitis occurring in neonates (aOR, 4.56; 95% CI, 2.14, 9.71) and older infants (aOR, 3.63; 95% CI, 1.72, 7.65). Among those with appendicitis, appendiceal perforation occurred in 77 (72.6%). Although preterm birth was an independent risk factor for appendiceal perforation when compared to age-matched controls (aOR, 3.54; 95% CI, 1.86, 6.76), among those with appendicitis, appendiceal perforation was not associated with birth prior to 37 weeks' gestation (OR, 0.79; 95% CI, 0.32, 1.91; P = 0.60). The authors conclude that preterm birth was a risk factor for development of appendicitis in the first year of life. Dr Goyal has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Appendicitis is a rare but life-threatening emergency in neonates and children under 1 year of age.1 Comprising <1% of pediatric appendicitis cases, infantile... You do not currently have access to this content.