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Evidence Library · Newborn procedures

Circumcision

A parental decision, with numbers on both sides.

Rates are falling. Across more than 1.5 million male newborn hospitalizations, the US rate fell from 54.1% in 2012 to 49.3% in 2022, with wide variation by group.

The American Academy of Pediatrics concluded that the health benefits outweigh the risks and justify access for families who choose it, but that the benefits are not sufficient to recommend it routinely. It is framed explicitly as a parental decision.

On the numbers: in 1,400,920 circumcised males, the overall adverse event rate was just under 0.5%. Complication rates rose about tenfold if the procedure was done between ages 1 and 9, and about twentyfold at age 10 or older. On the main benefit, across 12 studies and 402,908 boys, circumcision was associated with substantially less urinary tract infection (odds ratio 0.13). The review's own estimate is that at a baseline risk of about 1%, about 111 circumcisions would be needed to prevent one infection.

A discrepancy worth seeingThe large US claims study puts complications just under 0.5%. The systematic review of mixed international studies estimates bleeding and infection together at about 2%. Different data sources and definitions. Both are real published figures and you should see both.
Where this comes from:
249. American Academy of Pediatrics Task Force on Circumcision. Male circumcision. Pediatrics. 2012;130(3):e756-e785.
250. El Bcheraoui C, Zhang X, Cooper CS, Rose CE, Kilmarx PH, Chen RT. Rates of adverse events associated with male circumcision in US medical settings, 2001 to 2010. JAMA Pediatr. 2014;168(7):625-634.
251. Singh-Grewal D, Macdessi J, Craig J. Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies. Arch Dis Child. 2005;90(8):853-858.

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