Gastroschisis in Ontario, Canada: 2012-2018
Danielle K Bourque1, Lynn Meng2, Shelley Dougan2,3
1Regional Genetics Program, CHEO, Ottawa, Ontario, Canada.
Insights
Gastroschisis, a birth defect, is linked to young maternal age, low BMI, and rural living. Prenatal exposure to tobacco, alcohol, and drugs, especially marijuana, increases risk.
Area of Science:
- Reproductive Medicine
- Pediatric Surgery
- Public Health
Background:
- Gastroschisis is a congenital abdominal wall defect with unknown causes.
- Known associations include young maternal age, low socioeconomic status, low BMI, and smoking.
Purpose of the Study:
- To describe the epidemiology of gastroschisis in Ontario.
- To examine associations with maternal age, health, exposures, and geography.
Main Methods:
- Retrospective review of epidemiologic data from the Better Outcomes Registry & Network (BORN) Ontario database.
- Analysis of gastroschisis cases from 2012-2018.
Main Results:
- Birth prevalence was 2.31 cases/10,000 births, with no change over time or sex difference.
- Gastroschisis correlated with younger maternal age, lower maternal BMI, and first pregnancies.
- Maternal smoking, alcohol, drug use (especially marijuana), and rural residence were associated with increased risk.
Conclusions:
- Mothers of infants with gastroschisis are more likely to be young, thin, live rurally, and use substances prenatally.
- Identifies key risk factors for targeted public health interventions.
Background:
Gastroschisis is a congenital anomaly of the abdomen in which the intestines are found outside of the body at birth. While no clear causative factors have been identified, it is strongly associated with young maternal age. Other reported associations include low maternal socioeconomic status, low maternal body mass index (BMI), and smoking.
Methods:
This is a retrospective review of epidemiologic data relating to cases of gastroschisis in Ontario from 2012-2018 in the Better Outcomes Registry & Network (BORN) Ontario database, which is the province's prescribed maternal-newborn registry. We describe the epidemiology of gastroschisis in Ontario with respect to birth prevalence, maternal age, health, exposures, and geography.
Results:
The birth prevalence of gastroschisis is 2.31 cases/10,000 births. There was no apparent change in birth prevalence over the study period and there was no difference between male and female infants. Gastroschisis was associated with younger maternal ages and was inversely correlated with maternal BMI. Gastroschisis was associated with first completed pregnancy. Maternal diabetes was associated with a lower birth prevalence of gastroschisis than average. Mothers of babies with gastroschsis were more likely to report use of tobacco, alcohol, and drugs during pregnancy than those without gastroschisis, with marijuana use showing the largest increase in birth prevalence of gastroschisis. Mothers living in rural areas were more likely to have a baby with gastroschisis than those in urban centers, even after controlling for maternal age.
Conclusions:
This Ontario registry study reveals that mothers with babies with gastroschisis are more likely to be young and thin, live in rural areas, and report prenatal smoking, alcohol use, and drug use than women whose pregnancies do not have gastroschsis.
