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Increasing prevalence of gastroschisis in Utah
Kristen T Hougland1, Angela M Hanna, Rebecka Meyers
1Division of Neonatology, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA. kristen_hougland@pediatrix.com
Insights
Gastroschisis (a birth defect) prevalence in Utah has increased tenfold over 30 years. Risk factors include young maternal age, first pregnancy, and smoking, but outcomes were not linked to delivery mode or surgical closure.
Area of Science:
- Pediatric Surgery
- Neonatalogy
- Public Health Epidemiology
Background:
- Conflicting data exists on gastroschisis prevalence trends.
- This study investigated gastroschisis prevalence and infant characteristics in Utah.
Purpose of the Study:
- To determine gastroschisis prevalence trends in Utah live births.
- To identify risk factors and clinical characteristics of affected infants.
Main Methods:
- Utilized pediatric surgical and neonatal databases from Primary Children's Medical Center (1971-2002).
- Included only infants with Utah residency.
- Reviewed individual charts (1998-2002) and Utah Vital Statistics for infant/maternal data.
Main Results:
- Gastroschisis prevalence rose from 0.36 to 3.92 per 10,000 live births (P < .001).
- Associated risk factors: young maternal age, primigravida status, tobacco use.
- Higher birth weight correlated with shorter time to full enteric feedings (P = .03).
Conclusions:
- Gastroschisis prevalence has increased 10-fold in Utah over three decades.
- Delivery mode and surgical closure type did not impact time to full feedings.
Background:
Recent studies provide conflicting information about gastroschisis prevalence trends. The authors proposed that prevalence of gastroschisis in live births has increased in Utah and that characteristics of these infants would provide clinically useful information about treatment and outcomes.
Methods:
Primary Children's Medical Center (PCMC) is the sole pediatric surgical referral hospital for Utah. The authors used both pediatric surgical and neonatal databases to identify gastroschisis cases at PCMC from 1971 through 2002. Only infants whose mothers had a primary residence in Utah were included. Individual charts were reviewed for infant characteristics for cases from 1998 through 2002. Utah Vital Statistics Reports were used to determine live birth rates and general infant and maternal characteristics.
Results:
Gastroschisis prevalence increased from 0.36 to 3.92 cases per 10,000 live births over 31 years (P < .001). Young maternal age, primigravida status, and tobacco use were associated risk factors. Using the time required to achieve full enteric feedings at targeted volume and caloric density as a measurement of outcome, we found no association between delivery mode or surgical closure type (primary or secondary) and time to full feedings. Higher birth weight was associated with decreased time to full feedings (P = .03).
Conclusions:
Gastroschisis prevalence has increased 10-fold over the past 3 decades in Utah.