141 Prenatal Risk Factors Associated with Increasing Incidence of Infantile Hemangiomas

Incidence of infantile hemangiomas has steadily increased over the past 35 years, correlating with decreasing gestational age at birth and birth weight. Associated prenatal risk factors have not yet been well studied.We sought to identify prenatal risk factors associated with the development of IH by comparing prenatal characteristics and pregnancy complications and their trends over time.Using the Rochester Epidemiology Project we identified 917 birth mothers of 999 infants previously diagnosed with IH between January 1, 1976 and December 31, 2010, of which 869 were matched to control mothers based on sex and birth date of the case infant and age of the case birth mother. Demographics, prenatal and perinatal features were collected upon medical record review and compared between cases and controls using conditional logistic regression. Prenatal risk factors found to correlate with the development of IH in comparison to controls included use of assisted reproduction technology (ART) (p=0.001), placental abruption (p=0.017), prenatal progesterone use (p<0.001), corticosteroid use (p<0.001), gestational hypertension (p= 0.043) gestational diabetes (GDM) (p=0.008), preeclampsia (p=0.024), and forceps-assisted vaginal delivery (FAVD) (p=0.017). After adjusting for gestational age, ART, prenatal progesterone use, GDM, and FAVD remained statistically significant. Over the 35-year study period, increasing incidence of ART, prenatal progesterone use, and GDM was also demonstrated among the cases (p<0.001), a finding that correlates with increasing incidence of IH. Development of IH is linked to GDM as well as to FAVD, both of which are novel findings. In addition, the associations between IH and previously-reported prenatal characteristics including ART, prenatal progesterone use, and pre-eclampsia were confirmed. Increasing incidence of ART, GDM, and prenatal progesterone use over the past 35 years may be contributing to the concurrently increasing incidence of IH.