Maternal risk factors for gastroschisis: A population‐based case–control study

Raitio, Arimatias; Tauriainen, Tuomas; Leinonen, Maarit K.; Syvänen, Johanna; Kemppainen, Teemu; Löyttyniemi, Eliisa; Sankilampi, Ulla; Gissler, Mika; Hyvärinen, Anna; Helenius, Ilkka

doi:10.1002/bdr2.1703

Cited by 21 publications

(15 citation statements)

References 40 publications

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“…These include young maternal age, rural environment, cigarette smoking, low socioeconomic status and low maternal body mass index (BMI). 8,13,14 However, the prevalence of several risk factors stands juxtaposed with the increasing rate of gastroschisis. For example, BMI among reproductive aged women has been increasing, a trend that is expected to continue.…”

Section: Backg Rou N Dmentioning

confidence: 99%

The association between wildfire exposure in pregnancy and foetal gastroschisis: A population‐based cohort study

Park

Boles²,

Monavvari

et al. 2021

Paediatric Perinatal Epid

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Background Global climate change has led to an increase in the prevalence and severity of wildfires. Pollutants released into air, soil and groundwater from wildfires may impact embryo development leading to gastroschisis. Objective The objective of this study was to determine the association between wildfire exposure before and during pregnancy and the risk of foetal gastroschisis development. Methods This was a retrospective cohort study using The California Office of Statewide Health Planning and Development Linked Birth File linked to The California Department of Forestry and Fire Protection data between 2007 and 2010. Pregnancies complicated by foetal gastroschisis were identified by neonatal hospital discharge ICD‐9 code. Pregnancies were considered exposed to wildfire if the mother's primary residence zip code was within 15 miles to the closest edge of a wildfire. The exposure was further stratified by trimester or if exposed within 30 days prior to pregnancy. Multivariable log‐binomial regression analyses were performed to estimate the association between wildfire exposure in each pregnancy epoch and foetal gastroschisis. Results Between 2007 and 2010, 844,348 (40%) births were exposed to wildfire in California. Compared with births without wildfire exposure, those with first‐trimester exposure were associated with higher rates of gastroschisis, 7.8 vs. 5.7 per 10,000 births (adjusted relative risk [aRR] 1.28, 95% confidence interval [CI] 1.07, 1.54). Furthermore, those with prepregnancy wildfire exposure were also found to have higher rates of gastroschisis, 12.5 vs. 5.7 per 10,000 births, (aRR 2.17, 95% CI 1.42, 3.52). In contrast, second‐ and third‐trimester wildfire exposures were not associated with foetal gastroschisis. Conclusions Wildfire exposure within 30 days before pregnancy was associated with more than two times higher risk of foetal gastroschisis, whereas a 28% higher risk was demonstrated if exposure was in the first trimester.

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Section: Backg Rou N Dmentioning

confidence: 99%

The association between wildfire exposure in pregnancy and foetal gastroschisis: A population‐based cohort study

Park

Boles²,

Monavvari

et al. 2021

Paediatric Perinatal Epid

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“…S3 Table gives the method of ascertainment of maternal diabetes of the included studies. Of the 59 studies included, there were 27 studies from the European region (United Kingdom [ 26 – 30 ], Finland [ 31 , 32 ], Sweden [ 10 , 33 – 37 ], Denmark [ 10 , 28 , 35 , 38 , 39 ], Norway [ 6 , 28 , 40 , 41 ], Hungary [ 7 , 42 – 45 ], Germany [ 28 , 46 ], Netherlands [ 28 ], Belgium [ 28 ], Wales [ 28 , 30 ], Ireland [ 28 , 30 ], Switzerland [ 28 ], France [ 28 , 47 ], Italy [ 28 , 48 , 49 ], Spain [ 28 ], Portugal [ 28 ], and Malta [ 28 ]), 25 studies from North/South America (United States [ 4 , 5 , 11 , 12 , 14 , 50 – 57 ], Canada [ 50 , 58 – 68 ], and Brazil [ 69 ]), and 7 studies from the Asian-Pacific region (China [ 70 – 72 ...…”

Section: Resultsmentioning

confidence: 99%

Risks of specific congenital anomalies in offspring of women with diabetes: A systematic review and meta-analysis of population-based studies including over 80 million births

et al. 2022

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Background Pre-gestational diabetes mellitus (PGDM) has been known to be a risk factor for congenital heart defects (CHDs) for decades. However, the associations between maternal PGDM and gestational diabetes mellitus (GDM) and the risk of specific types of CHDs and congenital anomalies (CAs) in other systems remain under debate. We aimed to investigate type-specific CAs in offspring of women with diabetes and to examine the extent to which types of maternal diabetes are associated with increased risk of CAs in offspring. Methods and findings We searched PubMed and Embase from database inception to 15 October 2021 for population-based studies reporting on type-specific CAs in offspring born to women with PGDM (combined type 1 and 2) or GDM, with no limitation on language. Reviewers extracted data for relevant outcomes and performed random effects meta-analyses, subgroup analyses, and multivariable meta-regression. Risk of bias appraisal was performed using the Cochrane Risk of Bias Tool. This study was registered in PROSPERO (CRD42021229217). Primary outcomes were overall CAs and CHDs. Secondary outcomes were type-specific CAs. Overall, 59 population-based studies published from 1990 to 2021 with 80,437,056 participants met the inclusion criteria. Of the participants, 2,407,862 (3.0%) women had PGDM and 2,353,205 (2.9%) women had GDM. The meta-analyses showed increased risks of overall CAs/CHDs in offspring born to women with PGDM (for overall CAs, relative risk [RR] = 1.99, 95% CI 1.82 to 2.17, P < 0.001; for CHDs, RR = 3.46, 95% CI 2.77 to 4.32, P < 0.001) or GDM (for overall CAs, RR = 1.18, 95% CI 1.13 to 1.23, P < 0.001; for CHDs, RR = 1.50, 95% CI 1.38 to 1.64, P < 0.001). The results of the meta-regression analyses showed significant differences in RRs of CAs/CHDs in PGDM versus GDM (all P < 0.001). Of the 23 CA categories, excluding CHD-related categories, in offspring, maternal PGDM was associated with a significantly increased risk of CAs in 21 categories; the corresponding RRs ranged from 1.57 (for hypospadias, 95% CI 1.22 to 2.02) to 18.18 (for holoprosencephaly, 95% CI 4.03 to 82.06). Maternal GDM was associated with a small but significant increase in the risk of CAs in 9 categories; the corresponding RRs ranged from 1.14 (for limb reduction, 95% CI 1.06 to 1.23) to 5.70 (for heterotaxia, 95% CI 1.09 to 29.92). The main limitation of our analysis is that some high significant heterogeneity still persisted in both subgroup and sensitivity analyses. Conclusions In this study, we observed an increased rate of CAs in offspring of women with diabetes and noted the differences for PGDM versus GDM. The RRs of overall CAs and CHDs in offspring of women with PGDM were higher than those in offspring of women with GDM. Screening for diabetes in pregnant women may enable better glycemic control, and may enable identification of offspring at risk for CAs.

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“…The results obtained, in which the cut-off criterion for a maternal age of 25 years is adopted, are consistent with the results of studies by other researchers. 26,29 Anderson et al clearly indicate that the probability of defect occurrence decreases with maternal age. 17 Some authors observed a statistically significant frequency for the development of the abdominal wall defect in new-borns of mothers under 20 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…There is also evidence that primiparity is a statistically significant risk factor for gastroschisis. 29 The highest risk of giving birth to an infant with gastroschisis was demonstrated for primiparas. This is confirmed by the current study, i.e.…”

Section: Discussionmentioning

confidence: 99%

Gastroschisis: methods and early outcomes of surgical treatment

et al. 2021

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Introduction: Gastroschisis is a congenital anomaly in which loops of intestine are displaced outside the abdominal cavity through a defect in the abdominal wall. The incidence is steadily increasing. It is particularly attributed to young maternal age. The defect requires urgent surgical intervention after birth. Aim: The article aims to present the methods and early outcomes of surgical treatment of new-borns with gastroschisis in the context of pre- and postnatal examinations, and attempts to identify risk factors for the occurrence of the defect. Material and methods: The study used data derived from medical records of 18 patients of the Regional Specialist Children’s Hospital in Olsztyn. Prenatal, peri- and postoperative outcomes were analysed. The new-borns were classified with simple and complex gastroschisis. Results and discussion: The defect was diagnosed prenatally in 15 new-borns. In 16 cases, gestation was terminated by caesarean section. The mean maternal age at birth was 23 years; 14 woman were pregnant for the first time. All new-borns were operated on on day 1 of life. In 14 patients, primary closure of the abdominal wall was performed. The mean duration of mechanical ventilation was 13.31 days, of total parenteral nutrition – 29 day, to the first administration of enteral nutrition – 11.88 days and the mean length of hospital stay was 39.75 days, in the group of infants with simple gastroschisis. Conclusions: Gastroschisis is a severe anomaly causing an immediate threat to life. The optimal treatment procedure is the primary closure of the abdominal wall. The use of silastic sac enables the staged closure. Risk factors include young maternal age and primiparity.

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Maternal risk factors for gastroschisis: A population‐based case–control study

Cited by 21 publications

References 40 publications

The association between wildfire exposure in pregnancy and foetal gastroschisis: A population‐based cohort study

The association between wildfire exposure in pregnancy and foetal gastroschisis: A population‐based cohort study

Risks of specific congenital anomalies in offspring of women with diabetes: A systematic review and meta-analysis of population-based studies including over 80 million births

Gastroschisis: methods and early outcomes of surgical treatment

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