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Risk of gastroschisis with maternal genitourinary infections: the US National birth defects prevention study 1997-2011.

ABSTRACT: OBJECTIVE:To assess the association between occurrence and timing of maternal self-reported genitourinary tract infection (urinary tract infections [UTIs] and/or sexually transmitted infection [STI]) and risk for gastroschisis in the offspring. DESIGN:Population-based case-control study. SETTING:National Birth Defects Prevention Study, a multisite study in the USA. PARTICIPANTS:Mothers of 1366 gastroschisis cases and 11?238 healthy controls. MAIN OUTCOME MEASURES:Crude and adjusted ORs (aORs) with 95% CIs. RESULTS:Genitourinary infections were frequent in case (19.3%) and control women (9.9%) during the periconceptional period (defined as 3?months prior to 3?months after conception). UTI and/or STI in the periconceptional period were associated with similarly increased risks for gastroschisis (aOR 1.5, 95%?CI 1.3 to 1.8; aOR 1.6, 95% CI 1.2 to 2.3, respectively). The risk was increased with a UTI before (aOR 2.5; 95% CI 1.4 to 4.5) or after (aOR 1.7; 95% CI 1.1 to 2.6) conception only among women ?25 years of age. The risk was highest among women <20 years of age with an STI before conception (aOR 3.6; 95% CI 1.5 to 8.4) and in women ?25 years of age, the risk was similar for before (aOR 2.9; 95% CI 1.0 to 8.5) and after (aOR 2.8; 95% CI 1.3 to 6.1) conception. A specific STI pathogen was reported in 89.3% (50/56) of cases and 84.3% (162/191) of controls with Chlamydia trachomatis the most common (25/50 cases, 50%; 58/162 controls, 36%) and highest among women <20 years of age (16/25 cases, 64%; 22/33 controls, 67%). CONCLUSIONS:UTI and/or STI were associated with an increased risk for gastroschisis, with the strength of the association varying by maternal age and timing of infection.

SUBMITTER: Feldkamp ML

PROVIDER: S-EPMC6475179 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Risk of gastroschisis with maternal genitourinary infections: the US National birth defects prevention study 1997-2011.

Feldkamp Marcia L ML Arnold Kathryn E KE Krikov Sergey S Reefhuis Jennita J Almli Lynn M LM Moore Cynthia A CA Botto Lorenzo D LD

BMJ open 20190330 3

<h4>Objective</h4>To assess the association between occurrence and timing of maternal self-reported genitourinary tract infection (urinary tract infections [UTIs] and/or sexually transmitted infection [STI]) and risk for gastroschisis in the offspring.<h4>Design</h4>Population-based case-control study.<h4>Setting</h4>National Birth Defects Prevention Study, a multisite study in the USA.<h4>Participants</h4>Mothers of 1366 gastroschisis cases and 11 238 healthy controls.<h4>Main outcome measures< ...[more]

PMID: 30928950

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Project description:BackgroundGastroschisis is particularly prevalent among offspring of young women and has increased over recent decades. Although previous studies suggest that maternal alcohol consumption is associated with increased gastroschisis risk, none have explored whether maternal age modifies that association.ObjectiveThe objective of the study was to evaluate associations between self-reported maternal periconceptional alcohol consumption (1 month prior through the third month after conception) and risk of gastroschisis among offspring, by maternal age.MethodsWe used data from the National Birth Defects Prevention Study (NBDPS), a multi-site population-based case-control study. The analysis included 1450 gastroschisis cases and 11,829 unaffected liveborn controls delivered during 1997-2011 in ten US states. We estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the individual and joint effects of alcohol consumption and young maternal age at delivery (<25 years vs ≥25 years) on gastroschisis risk. We estimated the relative excess risk due to interaction (RERI) to quantify additive interaction.ResultsPericonceptional alcohol consumption was common regardless of maternal age (women <25 years: cases 38.8%, controls 29.3%; women ≥25: cases 43.5%, controls 39.5%). Compared with women ≥25 years who did not consume alcohol, we observed increased risk of gastroschisis among women <25 years, with higher estimates among those who consumed alcohol (women <25 years who did not consume alcohol. aOR 5.90, 95% CI 4.89, 7.11; women <25 years who did consume alcohol: aOR 8.21, 95% CI 6.69, 10.07). Alcohol consumption among women ≥25 years was not associated with gastroschisis (aOR 1.12, 95% CI 0.88, 1.42). This suggests super-additive interaction between alcohol consumption and maternal age (RERI -2.19, 95% CI 1.02, 3.36).ConclusionsPericonceptional alcohol consumption may disproportionately increase risk of gastroschisis among young mothers. Our findings support public health recommendations to abstain from alcohol consumption during pregnancy.

Dataset Information

Risk of gastroschisis with maternal genitourinary infections: the US National birth defects prevention study 1997-2011.

Publications

Risk of gastroschisis with maternal genitourinary infections: the US National birth defects prevention study 1997-2011.

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