Gastroschisis in Ontario, Canada: 2012–2018

Abstract

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.

The Alberta Congenital Anomalies Surveillance System: a 40-year review with prevalence and trends for selected congenital anomalies, 1997–2019

“…42 An Ontario study (2012-2018) reported no trend. 43 Neither study included early fetal deaths or terminations. 42,43 Additional social risk factors include maternal smoking, use of marijuana, illicit drugs and alcohol, low BMI, poor nutrition and socioeconomic disadvantage.…”

“…43 Neither study included early fetal deaths or terminations. 42,43 Additional social risk factors include maternal smoking, use of marijuana, illicit drugs and alcohol, low BMI, poor nutrition and socioeconomic disadvantage. 43 There are fewer exposures to many of these risk factors in the Hutterite population, where there were no cases of gastroschisis between 1980 and 2016.…”

Trends in prevalence of gastroschisis in Brazil from 2007 to 2020: A national population‐based cross‐sectional study

“…Maternal health and behavioral data were not available in the SINASC database. Therefore, we could not evaluate factors quoted as related to gastroschisis, such as body mass index (Benjamin, Ethen, Canfield, & Mitchell, 2020; Bourque et al, 2020); tobacco, alcohol, and illicit drugs use (Bourque et al, 2020); sexually transmitted infections and urinary tract infections (Baer et al, 2015).…”

“…Maternal body mass index (BMI) was not available for our study, but data from Canada, United Kingdom and United States associate low pre‐pregnancy BMI and maternal age <20 years with increased risk of gastroschisis, which may suggest an etiological role related to biological immaturity (Bourque et al, 2020; Hale et al, 2017; Siega‐Riz et al, 2009).…”

Cannabis use in pregnancy and maternal and infant outcomes: A Canadian cross-jurisdictional population-based cohort study

“…Currently, the evidence is mixed and mostly limited to ecological studies. A more recent study, also using data from BORN Ontario for 2012 to 2018 found positive associations between maternal cannabis use and gastroschisis [ 28 ]. Additionally, there is evidence for the development of ventricular septal heart defects, esophageal atresia and diaphragmatic hernia [ 29 – 31 ].…”