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Prevalence and Correlates of Gastroschisis in 15 States, 1995 to 2005

Kirby, Russell S. PhD, MS; Marshall, Jennifer MPH; Tanner, Jean Paul MPH; Salemi, Jason L. MPH; Feldkamp, Marcia L. PhD, PA; Marengo, Lisa MS; Meyer, Robert E. PhD; Druschel, Charlotte M. MD, MPH; Rickard, Russel MS; Kucik, James E. PhD, MPH

doi: 10.1097/AOG.0b013e31829cbbb4
Original Research

OBJECTIVE: To identify trends in the prevalence and epidemiologic correlates of gastroschisis using a large population-based sample with cases identified by the National Birth Defects Prevention Network over the course of an 11-year period.

METHODS: This study examined 4,713 cases of gastroschisis occurring in 15 states during 1995–2005, using public use natality data sets for denominators. Multivariable Poisson regression was used to identify statistically significant risk factors, and Joinpoint regression analyses were conducted to assess temporal trends in gastroschisis prevalence by maternal age and race and ethnicity.

RESULTS: Results show an increasing temporal trend for gastroschisis (from 2.32 per 10,000 to 4.42 per 10,000 live births). Increasing prevalence of gastroschisis has occurred primarily among younger mothers (11.45 per 10,000 live births among mothers younger than age 20 years compared with 5.35 per 10,000 among women aged 20 to 24 years). In the multivariable analysis, using non-Hispanic whites as the referent group, non-Hispanic black women had the lowest risk of having a gastroschisis-affected pregnancy (prevalence ratio 0.42, 95% confidence interval [CI] 0.37–0.48), followed by Hispanics (prevalence ratio 0.86, 95% CI 0.81–0.92). Gastroschisis prevalence did not differ by newborn sex.

CONCLUSIONS: Our findings demonstrate that the prevalence of gastroschisis has been increasing since 1995 among 15 states in the United States, and that higher rates of gastroschisis are associated with non-Hispanic white maternal race and ethnicity, and maternal age younger than 25 years (particularly younger than 20 years of age).

LEVEL OF EVIDENCE: III

The prevalence of gastroschisis has increased from 1995 to 2005 and is highest among non-Hispanic white women and women younger than 25 years of age.

Birth Defects Surveillance Program, Department of Community and Family Health, and the Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida; the Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah; the Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas; the North Carolina Birth Defects Monitoring Program, State Center for Health Statistics, North Carolina Division of Public Health, Raleigh, North Carolina; the New York State Department of Health, Troy, New York; the Colorado Department of Public Health and Environment, Denver, Colorado; and the Division of Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.

Corresponding author: Russell S. Kirby, PhD, MS, Birth Defects Surveillance Program, University of South Florida, 13201 Bruce B. Downs Boulevard, MDC56, Tampa, FL 33612-3805; e-mail: rkirby@health.usf.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

Presented in part at the 17th annual Maternal and Child Health Epidemiology conference, December 14–16, 2011, New Orleans, Louisiana.

The authors thank the following programs and their staff members for supplying data for this study: Arizona Birth Defects Monitoring Program; Bridget Mosley, MPH, and Arkansas Reproductive Health Monitoring System; California Birth Defects Monitoring Program, Maternal Child and Adolescent Health Division, California Department of Public Health; Colorado Responds to Children with Special Needs; Metropolitan Atlanta Congenital Defects Program, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention; Paul Romitti, PhD, and Iowa Registry for Congenital and Inherited Disorders; Kentucky Birth Surveillance Registry; New Mexico Birth Defects Prevention and Surveillance Program; New York Congenital Malformations Registry; North Carolina Birth Defects Monitoring Program; The Oklahoma Birth Defects Registry; William Aria, MPH, and the Rhode Island Birth Defects Program; Texas Birth Defects Epidemiology and Surveillance Branch; Utah Birth Defect Network; Katie Hutchinson, PhD, MSPH, Tom Bell, PhD, and the Washington State Birth Defects Surveillance System.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the California Department of Public Health.

© 2013 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.