Related Experiment Videos
Risk factors for gastroschisis
G Goldbaum1, J Daling, S Milham
1School of Public Health and Community Medicine, University of Washington, Seattle 98195.
Insights
Gastroschisis, a birth defect, is increasing. Risk factors include maternal smoking, young maternal age, inadequate prenatal care, and birth month. Smoking during pregnancy is a key area for further research.
Area of Science:
- Pediatric Surgery
- Birth Defects Research
- Epidemiology
Background:
- Gastroschisis (abdominal wall defect) prevalence at birth has risen.
- Understanding risk factors is crucial for addressing this increase.
Purpose of the Study:
- To identify risk factors associated with the increasing prevalence of gastroschisis.
- To investigate potential causes for the observed rise in gastroschisis cases.
Main Methods:
- Case-control study comparing 62 infants with gastroschisis to 617 unaffected infants.
- Analysis of Washington State birth certificates (1984-1987).
- Simultaneous adjustment for 14 potential risk factors.
Main Results:
- Infants born in Jan-Mar had higher risk (OR 2.2).
- Younger mothers (<25 years, especially <20) had higher risk (OR 4.1).
- Maternal smoking (OR 2.0) and inadequate prenatal care (OR 2.1) were associated with increased risk.
Conclusions:
- Maternal smoking during pregnancy is a plausible, modifiable risk factor for gastroschisis.
- Unidentified factors linked to birth month, maternal age, and prenatal care warrant further investigation.
- Further research on smoking's role is needed to explain the rising gastroschisis prevalence.
Abstract:
The prevalence at birth of gastroschisis, a rare abnormality of the abdominal wall, appears to have increased over the past decade. To characterize risk factors that might explain this increase, birth certificates for Washington State residents were compared for 62 infants born with gastroschisis during the years 1984 to 1987 and 617 randomly selected unaffected infants matched for birth year. After simultaneously adjusting for 14 potential risk factors, 4 factors stood out. Infants born during January, February, or March were at greater risk than infants born in any other months (odds ratio 2.2, 95% confidence interval 1.1, 4.1). Mothers less than 25 years old were at greater risk than mothers 25 years and older, with the highest risk to mothers less than 20 years old (odds ratio 4.1, 95% confidence interval 1.4, 12.0). Women who smoked during pregnancy were at greater risk than women who did not smoke (odds ratio 2.0, 95% confidence interval 1.03, 3.8). Finally, mothers receiving inadequate prenatal care were at greater risk than mothers receiving adequate prenatal care (odds ratio 2.1, 95% confidence interval 0.99, 4.6). Unidentified behavioral and environmental exposures may explain the associations with month of birth, maternal age, and prenatal care. However, smoking during pregnancy is a plausible risk factor that should be examined further as an explanation of the apparently increasing prevalence at birth of gastroschisis in developed nations.