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[An epidemiological investigation on gastroschisis in China during 1996 to 2000]
Guang-xuan Zhou1, Jun Zhu, Li Dai
1National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
Insights
Gastroschisis incidence in China remained stable between 1996-2000, with higher rates in rural areas and younger mothers. This birth defect carried a high perinatal mortality rate.
Area of Science:
- Epidemiology
- Medical Genetics
- Public Health
Context:
- Gastroschisis is a congenital abdominal wall defect.
- Understanding its epidemiological patterns is crucial for public health interventions.
- Previous data on gastroschisis trends in China were limited.
Purpose:
- To investigate the epidemiological characteristics of gastroschisis in China.
- To analyze incidence trends, geographical variations, and demographic risk factors.
- To determine perinatal mortality associated with gastroschisis.
Summary:
- A 1996-2000 study monitored 2,218,616 births across China, identifying 569 gastroschisis cases.
- The overall incidence was 2.56 per 10,000 births, with no significant increasing trend observed.
- Higher incidence was noted in rural areas, females, and mothers under 20, who faced a 5.4-fold increased risk.
- Perinatal mortality was high at 74.69%, with 41.46% diagnosed prenatally and 27.44% having other major defects.
Impact:
- Findings indicate stable gastroschisis incidence in China during the study period.
- Identifies key risk factors including maternal age and geographic location.
- Highlights the significant burden of gastroschisis due to high mortality and associated defects.
Objective:
To study the epidemiological characteristics of gastroschisis in China from 1996 to 2000.
Methods:
The birth defects monitoring program was undertaken in 450-466 hospitals from 31 provinces, cities and autonomous regions of China. Data about births including intrauterine death and stillbirth of 28 weeks of gestation was collected to report through the medical records over the time period 1996 to 2000. The maximal diagnosis time was up to 1 week after the delivery. The international Classification of Diseases of Ninth Revision with some modifications was used to code the birth defects.
Results:
A total of 569 cases with gastroschisis was found in 2,218,616 births monitored. The overall birth incidence of gastroschisis was 2.56 per 10,000 births during the monitored period. The increasing trend of incidence of gastroschisis hadn't been found (P > 0.05). The birth incidence of gastroschisis in rural areas was significant higher than that in urban areas (3.93 vs.1.98 per 10,000, P < 0.01). There was also significantly difference on birth incidence between female and male (2.64 vs. 2.15 per 10,000 births, P < 0.05). The birth incidence of gastroschisis in the mothers less than 20 years old was the highest among all mothers age, which were at 5.4 times increased risk relative to that of mother age of 25-29 years old. The overall perinatal mortality rate of gastroschisis was 74.69 percent, and 41.46 percent of gastroschisis were diagnosed before birth. 27.44 percent of cases were accompanied with other major defects.
Conclusions:
There was no increasing trend on the incidence of gastroschisis to be found in China during 1996 to 2000. The mother age less than 20 years old was at an increasing risk of fetal gastroschisis. The cases with gastroschisis had a high perinatal mortality rate.