NEW YORK (Reuters Health) – In premature neonates with inguinal hernia, the risk of incarceration is doubled when repair is delayed beyond 40 weeks post-conceptual age, according to a report in The Journal of Pediatrics

Dr. Marleta Reynolds and colleagues with Children’s Memorial Hospital, Northwestern University in Chicago, Illinois, note that prematurity is associated with an increased risk of inguinal hernia. While technical difficulties of operating in very small infants argue for delaying repair, this may increase the risk of incarceration possibly leading to bowel strangulation or testicular atrophy.

To determine the incidence of inguinal hernia in premature neonates and to identify risk factors for incarceration, the team examined statistics on the topic in the 2003 and 2006 Kids’ Inpatient Databases (KID).

National estimates for the year 2006 using weighted values from the 2006 KID indicated that during the birth hospitalization of 49,273 preemies, inguinal hernia was diagnosed in 1463 (3%), the researchers found.

Looking at actual numbers in the two years studied, they found that there were 2009 cases of inguinal hernia in premature neonates and that 1123 of them (55.9%) underwent hernia repair during their initial hospitalization. Incarceration occurred in 176 (15.7%).

“Repair after 40 weeks postconception was associated with a 2-fold risk of incarceration (27/131, 20.6%) compared with repair between 36 and 40 weeks (33/368, 9.0%; p<0.001) or before 36 weeks (28/248, 11.3%; p=0.014),” Dr. Reynolds and colleagues report. They say definitive recommendations cannot be made based on this study, since it lacks information about complications. “However,” the authors conclude, “this nationally representative data set provides support for the widespread practice of repairing inguinal hernias in premature infants before hospital discharge.” Reference:
Does Timing Matter? A National Perspective on the Risk of Incarceration in Premature Neonates with Inguinal Hernia

J Pediatr 2010.