Clinical Characteristics and Risk Factors for Infantile Hemangioma—A Case Control Study
24 March 2013
18 July 2013
05 September 2013 (online)
Objective To study the demographic and clinical features of infantile hemangioma in Uzbekistan; to learn in more detail the risk factors for developing this disease; and to identify clinical characteristics associated with complications, associated risks, and the need for systemic treatment.
Material and Methods A case-control study of 1,832 prospectively enrolled children and 1,832 controls matched with hemangiomas for age, sex, region, and hospital attending the maxilla facial surgery and dermatology departments between 2008 and 2012 was conducted. The patient data were collected from archives of three large hospitals in Uzbekistan Demographic and clinical presentations were summarized and compared with data from previous studies of hemangiomas. Predictive clinical factors for complications and/or treatment and potential risk factors for infantile hemangiomas were analyzed by logistic regression.
Results The clinical features of this study's patients were different from those of other race/ethnicity groups reported by previous studies with regard to the morphological subtypes, complications, and predictors for complications and/or surgical and medicament treatment. After adjustment, significant risk factors for hemangiomas included lower level of maternal education (odds ratio [OR], 0.61; 95% confidence interval [CI], 0.57–0.66), mother engaged in manual labor (OR, 1.29; 95% CI, 1.12–1.48), multiple gestation (OR, 1.20; 95% CI, 1.05–1.36), maternal medication use during the periconceptional period (OR, 2.08; 95% CI, 1.88–2.31), and a positive family history of hemangiomas (OR, 1.55; 95% CI, 1.40–1.72).
Conclusion Besides yielding several new findings with respect to risk factors for hemangiomas, the current study also suggests that the Uzbekistan clinical features of hemangiomas are somewhat different epidemiologically from those in the West.
- 1 Bruckner AL, Frieden IJ. Hemangiomas of infancy. J Am Acad Dermatol 2003; 48 (4) 477-493 , quiz 494–496
- 2 Perry BN, Govindarajan B, Bhandarkar SS , et al. Pharmacologic blockade of angiopoietin-2 is efficacious against model hemangiomas in mice. J Invest Dermatol 2006; 126 (10) 2316-2322
- 3 Pittman KM, Losken HW, Kleinman ME , et al. No evidence for maternal-fetal microchimerism in infantile hemangioma: a molecular genetic investigation. J Invest Dermatol 2006; 126 (11) 2533-2538
- 4 Ceisler EJ, Santos L, Blei F. Periocular hemangiomas: what every physician should know. Pediatr Dermatol 2004; 21 (1) 1-9
- 5 Frieden IJ, Reese V, Cohen D. PHACE syndrome. The association of posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities. Arch Dermatol 1996; 132 (3) 307-311
- 6 Metry DW, Hawrot A, Altman C, Frieden IJ. Association of solitary, segmental hemangiomas of the skin with visceral hemangiomatosis. Arch Dermatol 2004; 140 (5) 591-596
- 7 Metry DW, Haggstrom AN, Drolet BA , et al. A prospective study of PHACE syndrome in infantile hemangiomas: demographic features, clinical findings, and complications. Am J Med Genet A 2006; 140 (9) 975-986
- 8 Haggstrom AN, Drolet BA, Baselga E , et al. Prospective study of infantile hemangiomas: clinical characteristics predicting complications and treatment. Pediatrics 2006; 118 (3) 882-887
- 9 Chiller KG, Passaro D, Frieden IJ. Hemangiomas of infancy: clinical characteristics, morphologic subtypes, and their relationship to race, ethnicity, and sex. Arch Dermatol 2002; 138 (12) 1567-1576
- 10 Kaplan P, Normandin Jr J, Wilson GN, Plauchu H, Lippman A, Vekemans M. Malformations and minor anomalies in children whose mothers had prenatal diagnosis: comparison between CVS and amniocentesis. Am J Med Genet 1990; 37 (3) 366-370
- 11 Burton BK, Schulz CJ, Angle B, Burd LI. An increased incidence of haemangiomas in infants born following chorionic villus sampling (CVS). Prenat Diagn 1995; 15 (3) 209-214
- 12 Haggstrom AN, Drolet BA, Baselga E , et al; Hemangioma Investigator Group. Prospective study of infantile hemangiomas: demographic, prenatal, and perinatal characteristics. J Pediatr 2007; 150 (3) 291-294
- 13 Drolet BA, Swanson EA, Frieden IJ. Hemangioma Investigator Group. Infantile hemangiomas: an emerging health issue linked to an increased rate of low birth weight infants. J Pediatr 2008; 153 (5) 712-715 , e1
- 14 Petridou E, Trichopoulos D, Kalapothaki V , et al. The risk profile of childhood leukaemia in Greece: a nationwide case-control study. Br J Cancer 1997; 76 (9) 1241-1247
- 15 Adler NE, Ostrove JM. Socioeconomic status and health: what we know and what we don't. Ann N Y Acad Sci 1999; 896: 3-15
- 16 Yang J, Carmichael SL, Canfield M, Song J, Shaw GM. National Birth Defects Prevention Study. Socioeconomic status in relation to selected birth defects in a large multicentered US case-control study. Am J Epidemiol 2008; 167 (2) 145-154
- 17 Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg 1983; 18 (6) 894-900
- 18 Blei F, Walter J, Orlow SJ, Marchuk DA. Familial segregation of hemangiomas and vascular malformations as an autosomal dominant trait. Arch Dermatol 1998; 134 (6) 718-722
- 19 Walter JW, Blei F, Anderson JL, Orlow SJ, Speer MC, Marchuk DA. Genetic mapping of a novel familial form of infantile hemangioma. Am J Med Genet 1999; 82 (1) 77-83
- 20 Waner M, North PE, Scherer KA, Frieden IJ, Waner A, Mihm Jr MC. The nonrandom distribution of facial hemangiomas. Arch Dermatol 2003; 139 (7) 869-875
- 21 Garzon MC, Drolet BA, Baselga E , et al; Hemangioma Investigator Group. Comparison of infantile hemangiomas in preterm and term infants: a prospective study. Arch Dermatol 2008; 144 (9) 1231-1232
- 22 Berkman LF, Macintyre S. The measurement of social class in health studies: old measures and new formulations. IARC Sci Publ 1997; (138) 51-64
- 23 Fuentes-Afflick E, Hessol NA. Impact of Asian ethnicity and national origin on infant birth weight. Am J Epidemiol 1997; 145 (2) 148-155
- 24 MacMahon B, Trichopoulos D. Epidemiology: Principles and Methods. 2nd ed. Boston, MA: Little Brown & Co; 1996
- 25 Krieger N, Williams DR, Moss NE. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health 1997; 18: 341-378