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Infantile hypertrophic pyloric stenosis: maternal diabetes and perinatal exposure to non-macrolide antibiotics



Infant exposure to macrolide antibiotics is a risk factor for infantile hypertrophic pyloric stenosis (IHPS). The aim of the study was to establish whether perinatal exposure to non-macrolide antibiotics was a risk factor for IHPS.

Study design

A retrospective matched case-control study was performed using a database including all children born at Soroka University Medical Centre between 2006 and 2018. Cases and controls were compared using Student T-test and multiple logistic regression.


Of 189 461 children in the database, 63 infants were diagnosed with IHPS and underwent pyloromyotomy. There was no association between non-macrolide antibiotic exposure and IHPS. Maternal diabetes (DM) had an adjusted odds ratio for infants developing IHPS of 4.53 (p = 0.004).


The lack of association between exposure to non-macrolide antibiotics and IHPS suggests a quality unique to macrolides. An association between DM and IHPS may suggest elevated levels of IGF-1 have a role.

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Fig. 1: Figure 1 shows graphically the distribution of IHPS cases in the SUMC database per year.

Data availability

The data that support the findings of this study are available from KAM but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of KAM.


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Authors and Affiliations



SCE proposed the project idea as part of her medical school training at the Faculty of Health Sciences, Ben Gurion University of the Negev. She wrote the project proposal, performed the data collection, and was involved in data analysis, interpretation and writing the submitted paper. SY was the Statistical consultant for the project. She designed and performed the statistical analysis and the results tables. BY provided the SMC database set and contributed to the design of the project. ES contributed to the design of the project and the writing of the submitted paper. KAM developed the project proposal together with SCE and was involved in the data analysis, data interpretation and writing of the submitted paper.

Corresponding author

Correspondence to Kyla Anna Marks.

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Competing interests

There are no competing financial interests in relation to the work described. The Soroka University Medical Centre (SUMC) research ethics committee approved the study. The study was performed in accordance with the Declaration of Helsinki.

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Cohen Elias, S., Yarza, S., Yerushalmi, B. et al. Infantile hypertrophic pyloric stenosis: maternal diabetes and perinatal exposure to non-macrolide antibiotics. J Perinatol (2023).

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