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Rising birth prevalence of gastroschisis
Matthew Laughon1, Robert Meyer, Carl Bose
1Division of Neonatal-Perinatal Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
Insights
The birth prevalence of gastroschisis is rising, particularly in North Carolina, with a significant increase observed in infants born to mothers under 20. This trend suggests environmental factors may be involved.
Area of Science:
- Pediatric Surgery
- Neonatal Health
- Congenital Anomalies
Background:
- Gastroschisis, a congenital abdominal wall defect, has shown a concerning increase in incidence.
- Understanding the epidemiology of gastroschisis is crucial for public health initiatives.
Purpose of the Study:
- To determine the current birth prevalence of gastroschisis.
- To analyze trends in gastroschisis incidence using large-scale databases.
Main Methods:
- Review of a North Carolina statewide birth defects database.
- Analysis of data from a national neonatal healthcare provider database.
Main Results:
- Gastroschisis prevalence in North Carolina rose from 1.96 to 4.49 per 10,000 births (1997-2000).
- The increase was primarily driven by a rise in infants born to mothers younger than 20.
- National data showed an increase from 2.9 to 5 per 1000 patients (1997-2001).
Conclusions:
- The birth prevalence of gastroschisis is increasing in North Carolina and potentially nationwide.
- The sharp rise in a high-risk population suggests environmental or pharmacologic teratogens as potential causes.
- Further research into teratogenic exposures is warranted to understand gastroschisis etiology.
Objective:
Gastroschisis is a congenital anomaly that has been reported to be increasing in frequency. The objective of this study was to determine the birth prevalence of gastroschisis using two large databases.
Study Design:
We reviewed data from a statewide database and a national database from a neonatal health care provider, abstracting cases of gastroschisis.
Results:
In North Carolina, the birth prevalence of gastroschisis increased from 1.96 per 10,000 births in 1997 to 4.49 per 10,000 births in 2000 (p=0.0007). The overall increase was almost entirely because of the increase in infants born to mothers less than 20 years old. Among infants receiving care from the national neonatal provider, the prevalence of gastroschisis increased from 2.9 per 1000 patients in 1997 to five per 1000 patients in 2001 (p=0.044).
Conclusion:
The birth prevalence of gastroschisis is increasing in North Carolina, and this trend may be occurring nationally. The rapid change in the birth prevalence in the subset of population most at risk for gastroschisis implicates environmental or pharmacologic teratogens rather than changing population characteristics as a causal factor in the development of gastroschisis.