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Association Between Self-Reported Infections and Seropositivity Among Pregnant Women With Gastroschisis: A Case
M L Feldkamp1, E Baum-Jones2, E Y Enioutina3
1Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Birth Defects Research
|September 17, 2024
Summary
Younger maternal age and certain sexual behaviors are linked to gastroschisis risk. Chlamydia trachomatis infections were most prevalent in young mothers with gastroschisis, highlighting the need for better diagnostic methods.
Area of Science:
- Reproductive Health
- Maternal-Fetal Medicine
- Infectious Disease Epidemiology
Background:
- Gastroschisis, a congenital defect, poses the highest risk to women under 20.
- Understanding risk factors associated with gastroschisis is crucial for prevention and early detection.
Purpose of the Study:
- To investigate the association between maternal behaviors, sexually transmitted infections (STIs), and the risk of fetal gastroschisis.
- To evaluate the efficacy of self-reporting and medical records versus serological assays in detecting infections like Chlamydia trachomatis.
Main Methods:
- A case-control study involving pregnant women with (n=53) and without (n=102) fetal gastroschisis.
- Data collection included maternal interviews, blood samples for pathogen seropositivity using Serum Epitope Repertoire Analysis (SERA), and review of prenatal medical records.
- Comparison of self-reported risk factors and infections with serological findings for Chlamydia trachomatis and other pathogens.
Main Results:
- Maternal factors associated with gastroschisis cases included younger age at sexual debut, more sexual partners, being unmarried, partner changes, smoking, and reported STIs.
- Higher seropositivity for cytomegalovirus and, notably, Chlamydia trachomatis was observed in cases, particularly in women under 20.
- Self-report and prenatal records showed low sensitivity (27.8% and 3%, respectively) for identifying recent chlamydial infections compared to SERA.
Conclusions:
- Maternal engagement in behaviors increasing STI exposure risk is linked to gastroschisis.
- Younger women (<20 years) with gastroschisis exhibited the highest rates of Chlamydia trachomatis and overall STIs.
- The SERA assay offers a novel, effective approach for detecting subclinical infections impacting embryonic development, outperforming traditional reporting methods.
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