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The rising prevalence of gastroschisis and omphalocele in Tennessee
Sonya R Collins1, Marie R Griffin, Patrick G Arbogast
1Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232-2504, USA.
Insights
Congenital abdominal wall defects, including gastroschisis and omphalocele, have continued to rise in Tennessee through the 1990s and early 2000s. This trend persists even after accounting for demographic factors, warranting further investigation into underlying causes.
Area of Science:
- Pediatric Surgery
- Birth Defects Epidemiology
- Neonatal Health
Background:
- Gastroschisis and omphalocele are major congenital abdominal wall defects.
- Previous studies indicated increasing rates of these defects, primarily in the 1970s and 1980s.
- Conflicting evidence exists regarding trends in more recent years.
Purpose of the Study:
- To investigate the trends in congenital abdominal wall defects in Tennessee from 1985 to 2002.
- To determine if the increasing rates observed in earlier decades continued through the 1990s.
Main Methods:
- Utilized two independent data sources: birth certificates and Medicaid claims for the state of Tennessee.
- Analyzed data for the period spanning 1985 to 2002.
- Controlled for maternal age, race, and education in temporal trend analysis.
Main Results:
- A nearly 3-fold increase in congenital abdominal wall defects was observed between 1989 and 2001 using birth certificate data.
- A doubling of these defects was identified from Medicaid claims data during a similar period.
- The observed temporal increases remained significant after adjusting for maternal demographic factors.
Conclusions:
- The increasing trend of major congenital abdominal wall defects in Tennessee has persisted into the 1990s and early 2000s.
- These findings confirm a continued rise in gastroschisis and omphalocele rates in recent years.
- Further research is needed to identify the risk factors contributing to this ongoing increase.
Abstract:
Rates of the major congenital abdominal wall defects gastroschisis and omphalocele have been shown to be increasing over the past 10 to 20 years. Although much of the increase was seen in the 1970s and 1980s, there has been conflicting evidence as to whether similar trends exist for more recent years. Clinical observations from the major neonatal referral networks in Tennessee led us to question whether the rates of abdominal wall defects were continuing to increase throughout the 1990s. The purpose of this study was to describe the rates of congenital abdominal wall defects between 1985 and 2002 for the state of Tennessee using 2 independently collected data sources: birth certificates and Medicaid claims. There was nearly a 3-fold increase in congenital abdominal wall defects between 1989 and 2001 identified from birth certificates, and a doubling of these defects was identified from claims. Temporal increases persisted when controlling for maternal age, race, and education. We conclude that the increase in these important birth defects seen in earlier decades has persisted in Tennessee in recent years. Further elucidation of risk factors associated with the increase is warranted.
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