TY - JOUR
T1 - Gastroschisis in Europe – A prevalence and case-malformed control study
AU - Given, Joanne
AU - Loane, Maria
AU - Garne, Ester
AU - Nelen, Vera
AU - Barisic, Ingeborg
AU - Randrianaivo, Hanitra
AU - Khoshnood, Babak
AU - Wiesel, Awi
AU - Rissmann, Anke
AU - Lynch, Catherine
AU - Neville, Amanda, J.
AU - Pierini, Anna
AU - Bakker, Marian
AU - Klungsoyr, Kari
AU - Latos Bielenska, Anna
AU - Cavero-Carbonell, Clara
AU - Addor, Marie-Claude
AU - Zymak-Zakutnya, Natalya
AU - Tucker, David
AU - Dolk, Helen
PY - 2017/9/30
Y1 - 2017/9/30
N2 - A strong relationship between gastroschisis and young maternal age, and reports of increasing prevalence, point to the need for further research into environmental risk factors. A prevalence and case-malformed control study was conducted using data on 1,587 gastroschisis cases (of which 4% stillbirths, 11% terminations of pregnancy) from 18 European population based congenital anomaly registries, covering 8 million births 1995-2012. The prevalence of gastroschisis was 2.0 (95% CI 1.9-2.1) cases per 10,000 births and has stabilised over time. Maternal age-adjusted geographic variation in prevalence was however more than eightfold across registries. Associations or “signals” arising from the literature regarding first trimester maternal illness or medication use which were supported, or strongly supported, by our European data after adjustment for maternal age, registry and time period, were for maternal depression (OR 2.52, 95% CI 1.45-4.39), antidepressant use (OR 2.03, 95% CI 1.22-3.38), postnatal depression/psychosis (OR 8.32, 95% CI 2.56-27.01), sexually transmitted infections (OR 2.85, 95% CI 1.13-7.24), topical antivirals (OR 5.31, 95% CI 1.63–17.33) diclofenac (OR 2.70, 95% CI 0.98-7.45) and continuation of oral contraceptives in early pregnancy (OR 2.17, 95% CI 1.13-4.18). Exploratory analyses suggested associations with a wider range of maternal infections. Better understanding of these risk factors leading to appropriate interventions should help reduce the prevalence of gastroschisis.
AB - A strong relationship between gastroschisis and young maternal age, and reports of increasing prevalence, point to the need for further research into environmental risk factors. A prevalence and case-malformed control study was conducted using data on 1,587 gastroschisis cases (of which 4% stillbirths, 11% terminations of pregnancy) from 18 European population based congenital anomaly registries, covering 8 million births 1995-2012. The prevalence of gastroschisis was 2.0 (95% CI 1.9-2.1) cases per 10,000 births and has stabilised over time. Maternal age-adjusted geographic variation in prevalence was however more than eightfold across registries. Associations or “signals” arising from the literature regarding first trimester maternal illness or medication use which were supported, or strongly supported, by our European data after adjustment for maternal age, registry and time period, were for maternal depression (OR 2.52, 95% CI 1.45-4.39), antidepressant use (OR 2.03, 95% CI 1.22-3.38), postnatal depression/psychosis (OR 8.32, 95% CI 2.56-27.01), sexually transmitted infections (OR 2.85, 95% CI 1.13-7.24), topical antivirals (OR 5.31, 95% CI 1.63–17.33) diclofenac (OR 2.70, 95% CI 0.98-7.45) and continuation of oral contraceptives in early pregnancy (OR 2.17, 95% CI 1.13-4.18). Exploratory analyses suggested associations with a wider range of maternal infections. Better understanding of these risk factors leading to appropriate interventions should help reduce the prevalence of gastroschisis.
KW - Gastroschisis
KW - Congenital Abnormalities
KW - Pregnancy
KW - Sexually Transmitted Diseases
KW - Oral Contraceptives
KW - Depression
KW - Mental Disorders
KW - Antidepressive Agents
KW - Antiviral Agents
UR - https://www.sciencedirect.com/science/article/pii/S0890623817303507?via%3Dihub
U2 - 10.1016/j.reprotox.2017.06.059
DO - 10.1016/j.reprotox.2017.06.059
M3 - Article
VL - 72
SP - 23
JO - Reproductive Toxicology
JF - Reproductive Toxicology
ER -