The increasing incidence of newborn circumcision: data from the nationwideinpatient sample.

The increasing incidence of newborn circumcision: data from the
nationwide inpatient sample.

Nelson CP, Dunn R, Wan J, Wei JT.

Department of Urology, University of Michigan, Ann Arbor, Michigan
48109-0330, USA.

PURPOSE: Newborn circumcision is the most common surgical procedure in
the United States, yet there are few contemporary data regarding
circumcision rates or the factors that affect these rates. The goal of
this study was to determine trends in the national rate of newborn
circumcision between 1988 and 2000, and to evaluate patient and hospital
factors associated with newborn circumcision.

MATERIALS AND METHODS: The Nationwide Inpatient Sample provides
information on 5 million to 7 million inpatient stays per year. Newborn
male hospitalizations were selected, and those newborns who underwent
circumcision were identified using International Classification of
Disease-9 procedure codes. Weighted national estimates of circumcision
rates were calculated, and patient and hospital characteristics were
examined to identify factors associated with newborn circumcision.

RESULTS: We identified 4,657,402 newborn male hospitalizations during a
13-year period. Circumcision rates increased significantly with
time-48.3% of newborn males underwent circumcision in 1988 to 1991 vs
61.1% in 1997 to 2000 (p 0.0001). In multivariate regression analysis
the odds of circumcision increased by 6.8% per year during the study
period (p 0.0001). Patient characteristics associated with increased
odds of circumcision in the multivariate model included private
insurance (p 0.0001), higher socioeconomic status (p 0.0001), fewer
co-morbid diagnoses (p 0.0001) and black race (p 0.0001). Hospital
factors associated with increased odds of circumcision included
Northeast or Midwest geographic region and rural location.

CONCLUSIONS: There was a significant increase in the rate of newborn
circumcision between 1988 and 2000. The increase may be related to
increased recognition of the potential medical benefits of circumcision.
However, the increase may also result in a higher incidence of surgical
complications of circumcision.

http://www.ncbi.nlm.nih.gov/entrez/q..._uids=15711354