Original article
Increasing Prevalence of Gastroschisis: Population-based Study in California

https://doi.org/10.1016/j.jpeds.2007.11.037Get rights and content

Objective

To evaluate time trend of gastroschisis and examine the epidemiological risk factors for gastroschisis.

Study design

This population-based study analyzed the active surveillance data from the California Birth Defects Monitoring Program from 1987 to 2003.

Results

The overall birth prevalence of gastroschisis was 2.6 cases per 10,000 births (908 cases in >3.5 million births). In the adjusted analysis, by using the age of 25 to 29 years as the reference, mothers aged 12 to 15 years had a 4.2-times greater birth prevalence (95% CI, 2.5-7.0), and fathers aged 16 to 19 years and 20 to 24 years had 1.6- and 1.5-times greater birth prevalence (95% CI, 1.1-2.1 and 1.2-1.8), respectively. Compared with non-Hispanic whites and US-born Hispanic, both foreign-born Hispanics and blacks had adjusted prevalence ratio of 0.6 (95% CI, 0.5-0.7 and 0.4-0.9, respectively). In addition, nulliparity was also associated with gastroschisis. Independent of maternal age, paternal age, and maternal ethnicity, the birth prevalence increased 3.2-fold (95% CI, 2.3-4.3) during the 17-year study period.

Conclusions

The birth prevalence of gastroschisis continues to increase in California, and young, nulliparous women are at the greatest risk of having a child with gastroschisis.

Section snippets

Methods

Data were derived from the California Birth Defects Monitoring Program (CBDMP), a population-based active surveillance system for collecting information on births with congenital malformations in California. The data collection procedure consisted of 3 steps: case finding (review of all logs from hospitals and genetic medical centers to find potential cases), culling (chart review to identify the reportable cases from potential cases on the basis of the registry's criteria), and abstracting

Results

Between the years of 1987 and 2003, 908 cases of gastroschisis were diagnosed in 3,526,506 live births and stillbirths in California, resulting in a birth prevalence of 2.57 per 10,000 births; of the 908 cases, there were 863 live births, 40 stillbirths, and 5 therapeutic abortions. The distribution of the California cohort and the birth prevalence of gastroschisis are illustrated in Table I.

In unadjusted analyses (Table II), young, nulliparous mothers who were US-born Hispanics and had less

Discussion

This study demonstrated that the birth prevalence of gastroschisis has been gradually rising in the past 2 decades in California, independent of the 3 most significant risk factors, young maternal age, maternal ethnicity, and young paternal age. The strength of this study was the ascertainment system of the CBDMP. The registry was large, population-based, and also applied consistent detection procedures in the 17-year study period. Limitations of this study included potential incomplete

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