Gastroschisis and Cumulative Stressor Exposures

Area of Science:

• Reproductive Epidemiology
• Birth Defects Research
• Environmental Health

Background:

• Gastroschisis, a congenital abdominal wall defect, disproportionately affects offspring of younger mothers and its prevalence is rising.
• Numerous exposures have been linked to increased gastroschisis risk, independent of maternal age, with many associated with stress responses.

Purpose of the Study:

• To investigate the association between cumulative maternal stressor exposures in the first trimester and the risk of gastroschisis.
• To explore the role of cumulative environmental and lifestyle exposures in the etiology of gastroschisis.

Main Methods:

• A case-control study involving 1,261 mothers of gastroschisis cases and 10,682 mothers of controls from the National Birth Defects Prevention Study (1997-2011).
• Evaluated 16 first-trimester exposures including infections, medication use, substance use, and lifestyle factors as potential stressors.
• Calculated cumulative stressor scores and their association with gastroschisis risk using odds ratios.

Main Results:

• Mothers of gastroschisis cases reported significantly more stressor exposures compared to controls.
• A dose-response relationship was observed: the risk of gastroschisis increased with the number of cumulative stressor exposures (ORs ranging from 1.3 to 3.6).
• Cumulative stressor exposure did not explain the inverse association between maternal age and gastroschisis risk.

Conclusions:

• The accumulation of diverse maternal exposures is associated with an increased risk of gastroschisis.
• Findings support the hypothesis that stress-induced inflammation may be a key factor in the etiology of gastroschisis.
• Further research into the biological mechanisms linking maternal stress and inflammation to gastroschisis is warranted.