Spatial analysis of gastroschisis in Massachusetts and Texas
Published Date:Oct 13 2014
Source:Ann Epidemiol. 2014; 25(1):7-14.
Geographic Information Systems
Pubmed Central ID:PMC4255145
Funding:2P42ES007381-16A1/ES/NIEHS NIH HHS/United States
P42 ES007381/ES/NIEHS NIH HHS/United States
U01DD000493/DD/NCBDD CDC HHS/United States
U01DD000494/DD/NCBDD CDC HHS/United States
Previous research has suggested gastroschisis, a congenital malformation, may be linked to environmental or infectious factors and cases can occur in clusters. The objective of this study was to identify geographic areas of elevated gastroschisis risk.
Cases of gastroschisis were identified from birth defect registries in Massachusetts and Texas. Random samples of live births were selected as controls. Generalized additive models were used to create a continuous map surface of odds ratios (OR) by smoothing over latitude and longitude. Maternal age, race/ethnicity, education, cigarette smoking, and insurance status (MA only) were assessed for confounding. We used permutation tests to identify statistically significant areas of increased risk.
An area of increased risk was identified in north-central Massachusetts, but was not significant after adjustment (p-value=0.07; OR=2.0). In Texas, two statistically significant areas of increased risk were identified after adjustment (p-value=0.02; OR=1.3 and 1.2). Texas had sufficient data to assess the combination of space and time, which identified an increased risk in 2003 and 2004.
This study suggests there were areas of elevated gastroschisis risk in Massachusetts and Texas that cannot be explained by the risk factors we assessed. Additional exploration of underlying artifactual, environmental, infectious, or behavioral factors may further our understanding of gastroschisis.
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