Infantile Hemangiomas: An Emerging Health Issue Linked to an Increased Rate of Low Birth Weight Infants

doi:10.1016/j.jpeds.2008.05.043

The Journal of Pediatrics

Volume 153, Issue 5, November 2008, Pages 712-715.e1

https://doi.org/10.1016/j.jpeds.2008.05.043 Get rights and content

A total of 420 children with infantile hemangioma (IH) were compared with 353 age-matched controls. Using multivariate logistic regression, low birth weight was the most significant risk factor; for every 500-g decrease in birth weight, the risk of IH increased by 40%. A positive family history also increased the risk of IH (33% vs 15% of controls; P < .001).

Section snippets

Methods

Children with a diagnosis of IH (n = 420) prospectively enrolled from 2 sites (University of California San Francisco and Children's Hospital of Wisconsin) as part of a multicenter cohort study of IH¹ were compared with 353 children under age 2 years evaluated at these same 2 sites for diagnoses other than IH. The diagnosis of IH was confirmed by physical examination and clinical behavior of the lesions. All control subjects underwent a full skin examination that confirmed the absence of IH. A

Results

The mean age at study enrollment was 10.3 months in the control group and 11.1 months in the IH group. Those in the IH group were more likely to be female (P < .0001), white non-Hispanic (P < .0001), preterm (P < .0001), and LBW (P < .0001). Seventeen infants in the control group were the product of multiple gestation, compared with 42 infants in the IH group (P = .0064). Children born to women who had experienced miscarriages were more likely to have IH (P = .004). Chorionic villous sampling

Discussion

Besides reaffirming several known risk factors for IH (specifically female sex, white non-Hispanic race/ethnicity, and preterm birth), our findings demonstrate for the first time that LBW rather than permaturity per se is the most significant risk factor for developing IH. The prevalence of preterm and LBW infants in the United States continues to rise. In 2005, 8.2% of infants born in the United States had a birth weight < 2500 g, the highest percentage recorded since 1968, exceeding that in

References (11)

A.N. Haggstrom et al.
Prospective study of infantile hemangiomas: demographic, prenatal and perinatal characteristics
J Pediatr
(2007)
K. Batta et al.
Randomized controlled study of early pulsed-dye laser treatment of uncomplicated childhood haemangiomas: results of a 1-year analysis
Lancet
(2002)
A.N. Haggstrom et al.
Prospective study of infantile hemangiomas, part II: clinical characteristics predicting complications and treatment
Pediatrics
(2006)
B.A. Drolet et al.
Perinatal characteristics of infants with hemangiomas
ISSVA
(2006)
B.K. Burton et al.
Increased incidence of haemangioma in infants born following chorioinic villus sampling
Prenat Diagn
(1995)

There are more references available in the full text version of this article.

Cited by (184)

Vascular Anomalies and Other Cutaneous Congenital Defects
2023, Avery's Diseases of the Newborn
Infantile hemangioma. Part 1: Epidemiology, pathogenesis, clinical presentation and assessment
2021, Journal of the American Academy of Dermatology
Infantile hemangioma (IH) is the most common pediatric vascular tumor. Its pathogenesis is poorly understood but thought to represent an aberrant response of pluripotent stem cells to stimuli such as hypoxia and the renin-angiotensin system. IH usually appears during the first few weeks of life and follows a characteristic natural trajectory of proliferation and involution. Their clinical appearance depends on their depth and distribution. Classification comprises superficial, mixed, and deep IH as well as IH with minimal or arrested growth. Multifocal IHs are more likely to be associated with infantile hepatic hemangioma and, although the need for screening based on a specific number of IH has been recently debated, 5 remains the most widely acceptable cutoff point. Large facial IHs warrant investigation for posterior fossa malformations, hemangioma, arterial anomalies, cardiac defects or aortic coarctation and eye anomalies (PHACE) syndrome. Lumbar IHs warrant investigation for lower body IH and other cutaneous defects, urogenital anomalies, ulceration, myelopathy, bony deformity, anorectal malformations, arterial anomalies, and renal anomalies (LUMBAR) syndrome. Complications of IH include ulceration, obstruction or functional impairment, hypothyroidism, and cosmetic sequelae. Differential diagnoses mostly consist of other vascular tumors and vascular malformations, although IH may sometimes mimic nonvascular tumors or developmental anomalies. Diagnosis is usually clinical and biopsy is rarely indicated. High-frequency ultrasonography may help with the differential diagnosis, particularly with subcutaneous lesions. Referral to other specialists may be required in specific cases.
Infantile Hemangioma and the Risk Factors in a Japanese Population: A Nationwide Longitudinal Study—The Japan Environment and Children's Study
2021, Journal of Investigative Dermatology
Neonatal dermatology
2021, Pediatric Dermatology
The prevalence, complications, and risk factors for infantile hemangioma: a systematic review and meta-analysis
2024, International Journal of Dermatology
Infantile Hemangioma: A Cross-Sectional Observational Study
2023, Life

View all citing articles on Scopus

: This study was funded by the Dermatology Foundation, Children's Research Institute, and American Skin Association. The authors have no potential conflicts of interest to declare.

^⁎: A list of members of the Hemangioma Investigator Group is available in the Appendix (www.jpeds.com).

View full text

Clinical and laboratory observationInfantile Hemangiomas: An Emerging Health Issue Linked to an Increased Rate of Low Birth Weight Infants

Section snippets

Methods

Results

Discussion

J Pediatr

Lancet

Prospective study of infantile hemangiomas, part II: clinical characteristics predicting complications and treatment

Pediatrics

Perinatal characteristics of infants with hemangiomas

ISSVA

Increased incidence of haemangioma in infants born following chorioinic villus sampling

Prenat Diagn

Clinical and laboratory observation
Infantile Hemangiomas: An Emerging Health Issue Linked to an Increased Rate of Low Birth Weight Infants