Article

Hispanic ethnicity and acculturation, maternal age and the risk of gastroschisis in the National Birth Defects Prevention Study

Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston, Texas.
Birth Defects Research Part A Clinical and Molecular Teratology (Impact Factor: 2.09). 08/2013; 97(8). DOI: 10.1002/bdra.23140
Source: PubMed

ABSTRACT

Unlabelled:
Studies indicate that gastroschisis is associated with maternal age, ethnicity, and acculturation. This analysis was conducted to further define the associations between gastroschisis and parental Hispanic ethnicity and acculturation, and to determine whether such associations vary by maternal age.

Methods:
This study was based on data from mothers of 753 gastroschisis cases and 6,496 control infants in the National Birth Defects Prevention Study. The relationships between gastroschisis and both parental Hispanic ethnicity and acculturation, within maternal age strata (<20 versus ≥20 years at conception), were assessed using logistic regression and principal component analyses.

Results:
The risk of gastroschisis in offspring of women <20 years old was not significantly associated with parental Hispanic ethnicity or acculturation. Among mothers ≥20 years old, US-born non-Hispanic white parents had a lower risk of gastroschisis in offspring as compared to either US-born Hispanic (odds ratios [ORs] ranging from 0.55 to 0.60) or English-speaking Hispanic (ORs ranging from 0.58 to 0.65) parents. Further, compared with US born Hispanic women ≥20 years, the risk of gastroschisis was lower for Hispanic women who had lived in the US <5 years (OR=0.35, 95% confidence interval [CI]: 0.17, 0.74) or who migrated to the US at ≥20 years (OR=0.47, 95% CI: 0.25, 0.88).

Conclusion:
These results provide further evidence that gastroschisis risk is associated with ethnicity and some aspects of acculturation. Additionally, these associations were limited to the offspring of women who are ≥20 at the time of conception.

Download full-text

Full-text

Available from: Philip J Lupo
    • "iagnosis and management of birth defects , and this could have influenced a concentration of gastroschisis cases . As teenage mothers accounted for approximately 60 per cent of our cases , lifestyle variables have been reported as more prevalent in these age groups and could play a role in the etiology of gastroschisis ( Reefhuis and Honein 2004 ; Khodr et al . 2013 ) . In our results ( Table 3 ) , as in others ( Werler et al . 1992 ; Bird et al . 2009 ; Richardson et al . 2011 ) , periconceptional alcohol consumption was found to be associated with gastroschisis . Alcohol exposure during this period may affect processes of development , or interact with other genetic or metabolic factors ( Richard"
    [Show abstract] [Hide abstract]
    ABSTRACT: Mexico is recognized as a country with a high prevalence of gastroschisis, although the cause of this remains unclear. We define the prevalence and potential risk factors for gastroschisis in a public hospital from West México. A case-control study was conducted among 270 newborns, including 90 patients with nonsyndromic gastroschisis (cases) and 180 infants without birth defects (controls), born all during the period 2009 to 2013 at the Hospital Civil de Guadalajara “Dr. Juan I. Menchaca” (Guadalajara, Mexico), from out of a total of 51,145 livebirths. Potential maternal risk factors for gastroschisis were compared using multivariate logistic regression analysis to evaluate the deviance explained by different variables of interest. The overall prevalence of gastroschisis in livebirths was 17.6 per 10,000 births (95% confidence interval [CI] 14.0-21.2), whereas in offspring of women ≤19 years old was 29.9 per 10,000 births (95% CI 21.9-38.0). Mothers ≤19 years (adjusted odds ratio [aOR] 2.8: 95% CI 1.5-5.1), anemia during pregnancy (aOR 10.7; 95% CI 2.0-56.9), and first-trimester exposure to hormonal contraceptives (aOR 3.7; 95% CI 1.0-13.0), and first-trimester alcohol consumption (aOR 3.4; 95% CI 1.6-7.3), were associated with gastroschisis. Contrarily, adjusted OR for pre-pregnancy BMI ≥25 kg/m2 has protective odds (aOR 0.2; 95% CI 0.1-0.5). Our results suggest an increased risk for gastroschisis among mothers under the age of 20, with anemia during pregnancy, and those who used hormonal contraceptives or consumed alcohol during early pregnancy, whereas, pre-pregnancy overweight has a protective OR, and they are discussed as clues in its pathogenesis.
    No preview · Article · Sep 2014 · Congenital Anomalies
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective. To analyze the possible association of maternal age with the risk of all congenital abnormalities (CAs) in a population-based large case-matched control data set. Methods. The Hungarian Case-Control Surveillance of Congenital Abnormalities included 21494 cases with isolated CA and their 34,311 matched controls. First the distribution of maternal age groups in 24 CA-groups and their matched controls was compared. In the second step young (19 yr or less) and advanced (35 yr or more) age groups were compared. Finally the subgroups of neural-tube defects, congenital heart defects and abdominal wall's CA were evaluated separately. Results. A higher risk of gastroschisis, congenital heart defects, particularly left sided obstructive defects, undescended testis and clubfoot was found in the youngest age group (19 yr or less) of cases. The higher proportion of pregnant women with advanced age (i.e. 35 yr or more) showed only a borderline excess in cases with clubfoot. The so-called U-shaped risk of maternal age distribution was found in cases with clubfoot and in the total group of isolated CAs. Conclusions. The maternal age is a contributing factor to the origin of some isolated CAs mainly in young pregnant women.
    No preview · Article · Apr 2014 · The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: In epidemiological studies at the estimation of risk factors in the origin of specified congenital abnormalities in general birth order (parity) is considered as confounder. The aim of this study was to analyze the possible association of first and high (four or more) birth order with the risk of congenital abnormalities in a population-based case-matched control data set. Study design: The large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities included 21,494 cases with different isolated congenital abnormality and their 34,311 matched controls. First the distribution of birth order was compared of 24 congenital abnormality groups and their matched controls. In the second step the possible association of first and high birth order with the risk of congenital abnormalities was estimated. Finally some subgroups of neural-tube defects, congenital heart defects and abdominal wall's defects were evaluated separately. Results: A higher risk of spina bifida aperta/cystica, esophageal atresia/stenosis and clubfoot was observed in the offspring of primiparous mothers. Of 24 congenital abnormality groups, 14 had mothers with larger proportion of high birth order. Ear defects, congenital heart defects, cleft lip± palate and obstructive defects of urinary tract had a linear trend from a lower proportion of first born cases to the larger proportion of high birth order. Birth order showed U-shaped distribution of neural-tube defects and clubfoot, i.e. both first and high birth order had a larger proportion in cases than in their matched controls. Conclusions: Birth order is a contributing factor in the origin of some isolated congenital abnormalities. The higher risk of certain congenital abnormalities in pregnant women with first or high birth order is worth considering in the clinical practice, e.g. ultrasound scanning.
    Full-text · Article · Jun 2014 · European Journal of Obstetrics & Gynecology and Reproductive Biology
Show more