Gastroschisis and Cumulative Stressor Exposures

Werler, Martha M.; Guéry, Esther; Waller, D. Kim; Parker, Samantha E.

doi:10.1097/ede.0000000000000860

Cited by 21 publications

(39 citation statements)

References 65 publications

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“…There have not been any observations published on animal models for this association. In a study exploring cumulative exposures among mothers of gastroschisis patients, the effect of a combined set of stressors, including prescription opioid use, was higher among older mothers ( 4 ), which is consistent with the finding in the ecologic analysis that the association between opioid prescription rates and gastroschisis appeared to be more pronounced in mothers aged ≥25 years. The findings from different study designs have disparate strengths and weaknesses.…”

Section: Discussionsupporting

confidence: 77%

Gastroschisis Trends and Ecologic Link to Opioid Prescription Rates — United States, 2006–2015

Short¹,

Stallings²,

Isenburg³

et al. 2019

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionsupporting

confidence: 77%

Gastroschisis Trends and Ecologic Link to Opioid Prescription Rates — United States, 2006–2015

Short¹,

Stallings²,

Isenburg³

et al. 2019

MMWR Morb. Mortal. Wkly. Rep.

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“…Fifty-eight studies11 24–80 concerning lifestyle and sociodemographic risk factors were included in the systematic review (online supplementary tables S1-S2). Twenty-nine studies11 29 32 34 37 38 40 41 46 48–51 53–55 59 60 62–66 69 73–75 79 80 were available for meta-analyses comprising 21 994 cases of gastroschisis. Among them, four studies were adjusted only for maternal age or for maternal age and body mass index (BMI).…”

Section: Resultsmentioning

confidence: 99%

“…Studies on lifestyle risk factors11 24–67 mainly investigated maternal smoking, illicit drug use, maternal alcohol consumption and maternal nutrition. Few studies investigated other maternal lifestyle habits (online supplementary table S1).…”

Section: Resultsmentioning

confidence: 99%

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Lifestyle and sociodemographic risk factors for gastroschisis: a systematic review and meta-analysis

et al. 2020

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BackgroundGastroschisis is strongly associated with young maternal age. This association suggests the need for further investigations on non-genetic risk factors. Identifying these risk factors is a public health priority in order to develop prevention strategies aimed at reducing the prevalence and health consequences in offspring.ObjectiveTo systematically assess and quantitatively synthesise the available epidemiological studies to evaluate the association between non-genetic risk factors and gastroschisis.MethodsLiterature from PubMed, EMBASE and Scopus was searched for the period 1990–2018. Epidemiological studies reporting risk estimates between lifestyle and sociodemographic risk factors and gastroschisis were included. Two pairs of reviewers independently extracted information on study characteristics following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and MOOSE (Meta-analysis Of Oservational Studies in Epidemiology) guidelines. Relative risk (RR) estimates were calculated across the studies and meta-analysis was performed using random-effects model.ResultsWe identified 58 studies. Meta-analyses were conducted on 29 studies. Maternal smoking (RR 1.56, 95% CI 1.40 to 1.74), illicit drug use (RR 2.14, 95% CI 1.48 to 3.07) and alcohol consumption (RR 1.40, 95% CI 1.13 to 1.70) were associated with an increased risk of gastroschisis. A decreased risk among black mothers compared with non-Hispanic white mothers (RR 0.49, 95% CI 0.38 to 0.63) was found. For Hispanic mothers no association was observed.ConclusionsExposure to smoking, illicit drugs and alcohol during pregnancy is associated with an increased risk of gastroschisis. A significantly decreased risk for black mothers was observed. Further epidemiological studies to assess the potential role of other environmental factors are strongly recommended.PROSPERO registration numberCRD42018104284.

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“…First, matching for maternal age and BMI during inclusion led to the subjects in the study groups being very similar in terms of the already known major factors associated with congenital gastroschisis. Second, the interviews and questionnaires were administered during pregnancy; in contrast, in the majority of studies, the interviews occurred after delivery (up to 1 to 2 years after birth), which suggests a long recall period . In addition, our cases were matched for gestational age, which reduced the bias between the groups regarding the recall of events, exposures, and the timing of these exposures.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for gastroschisis: A case–control study in a Brazilian population

Freitas

Centofanti

Osmundo-Junior

et al. 2020

Intl J Gynecology & Obste

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Objective: To evaluate risk factors associated with fetal gastroschisis.Methods: As a secondary aim of a larger case-control study, pregnant women attending the Fetal Medicine Unit at the Department of Obstetrics and Gynecology at Hospital das Clinicas, Sao Paulo University Medical School between July 1, 2013, and July 31, 2015, were allocated into either the gastroschisis group, where the woman was carrying a fetus with gastroschisis, or the control group, where the fetus was normal. Patients in the control group were matched at study entry for maternal age, preconception body mass index and weeks of gestation. In-person interviews were conducted during pregnancy to obtain data on demographic, medical, and social characteristics; exposure to substances; pregnancy history; the presence of chronic disease, urinary tract infections (UTIs), influenza, and fever; and the occurrence of stress events between the month before the last menstrual period and the first trimester of pregnancy. Results:Of 171 women included in the study, 57 were allocated to the gastroschisis group and 114 to the control group. There were significant associations between gastroschisis and maternal UTI (P=0.011), tobacco use (P=0.001), alcohol consumption (P≤0.001), and illicit drug use (P=0.012). After analysis by standard logistic regression, the remaining significant factors were UTI, tobacco use, and alcohol consumption.Conclusion: UTI and exposure to tobacco or alcohol just before conception and during early pregnancy were associated with an increase in the likelihood of fetal gastroschisis.

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Gastroschisis and Cumulative Stressor Exposures

Abstract: These findings show that gastroschisis risk appears to increase with accumulation of widely different types of exposures, consistent with the hypothesis that stress-induced inflammation might play an etiologic role.

Cited by 21 publications

References 65 publications

Gastroschisis Trends and Ecologic Link to Opioid Prescription Rates — United States, 2006–2015

Gastroschisis Trends and Ecologic Link to Opioid Prescription Rates — United States, 2006–2015

Lifestyle and sociodemographic risk factors for gastroschisis: a systematic review and meta-analysis

Risk factors for gastroschisis: A case–control study in a Brazilian population

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