Original article
Prospective Study of Infantile Hemangiomas: Demographic, Prenatal, and Perinatal Characteristics

https://doi.org/10.1016/j.jpeds.2006.12.003Get rights and content

Objectives

To characterize demographic, prenatal, and perinatal features of patients with infantile hemangiomas and to determine the importance of these factors in predicting rates of complication and treatment.

Study design

We conducted a prospective study at 7 U.S. pediatric dermatology clinics. A consecutive sample of 1058 children, aged 12 years and younger, with infantile hemangiomas was enrolled between September 2002 and October 2003. A standardized questionnaire was used to collect demographic, prenatal, perinatal, and hemangioma-specific data. National Vital Statistic System Data (NVSS) was used to compare demographic variables and relevant rates of prenatal events.

Results

In comparison with the 2002 United States National Vital Statistics System birth data, we found that infants with hemangiomas were more likely to be female, white non-Hispanic, premature (P < .0001) and the product of a multiple gestation (10.6% versus 3.1%; P < .001). Maternal age was significantly higher (P < .0001), and placenta previa (3.1%) and pre-eclampsia (11.8%) were more common.

Conclusions

Infants with hemangiomas are more likely to be female, white non-Hispanic, premature, and products of multiple gestations. Prenatal associations include older maternal age, placenta previa, and pre-eclampsia. No demographic, prenatal, and perinatal factors predicted higher rates of complications or need for treatment.

Section snippets

Study Design

A prospective study of patients with infantile hemangiomas was initiated in September 2002 by members of the Hemangioma Investigator Group (HIG) at 7 U.S. academic pediatric dermatology clinics. One additional site in Spain enrolled patients, but data from that site was not used in the analysis of demographic features because U.S. National Vital Statistics System (NVSS) birth data was used for comparison. The institutional review board at each participating institution approved the study

Group Characteristics

A total of 1058 U.S. patients were enrolled in a 1-year period. Most (68%) of our patients were younger than 1 year. Ninety percent of patients were 2 years or younger. A total of 750 patients (71%) were female, and 308 patients (29%) were male. White, non-Hispanic patients comprised 68.9% of patients. African-American and Hispanic patients comprised 2.8% and 14.4% of patients, respectively. Data on gestational age were available on 1047 patients, 214 (20.4%) of whom were born prematurely

Discussion

Identifying patient characteristics associated with the development of a birth defect or “birthmark” has traditionally been performed by using formal birth defect registries. Birth defect registries are tools used to identify demographic, prenatal, and perinatal characteristics and potential risk factors that can have both clinical and scientific implications. Unfortunately, hemangiomas, though considered a type of “birthmark” have not been included in such registries because their presence at

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Supported by the Dermatology Foundation and American Skin Association.

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