Spatial analysis of gastroschisis in the National Birth Defects Prevention Study
Published Date:Apr 06 2015
Source:Birth Defects Res A Clin Mol Teratol. 103(6):544-553.
Corporate Authors:The National Birth Defects Prevention Study
Pubmed Central ID:PMC4478213
Funding:2P42ES007381/ES/NIEHS NIH HHS/United States
FOA DD09-001/DD/NCBDD CDC HHS/United States
P42 ES007381/ES/NIEHS NIH HHS/United States
PA 02081/PHS HHS/United States
PA 96043/PHS HHS/United States
Gastroschisis is a birth defect where loops of bowel are protruding from the abdominal wall at birth. Previous research has suggested that gastroschisis cases can occur in clusters. The objective of this study was to identify if there were areas of elevated gastroschisis risk using data from the National Birth Defects Prevention Study (NBDPS), 1997 through 2007.
We obtained data on cases (n=371) through population-based birth defects surveillance systems in Arkansas, California, and Utah; controls (n=2,359) were selected from the same geographic areas as cases. Mothers were interviewed on demographic information and exposures during pregnancy, including residential history. We used first trimester maternal addresses and generalized additive models to create a continuous map surface of odds ratios (OR) by smoothing over latitude and longitude. Permutation tests were used to assess whether location of maternal residence was important and identify locations with statistically significant ORs.
In Arkansas, adjusted ORs in the southwest corner were 2.0 and the global deviance was not statistically significant (p-value: 0.57). Adjusted ORs for California indicated areas of increased risk with ORs 1.3 (p-value: 0.34). In Utah, the adjusted ORs were elevated (OR: 2.4) in the south-eastern corner of the study area (p-value: 0.34).
The results of this study, while not statistically significant, suggest there were spatial variations in gastroschisis births. We cannot rule out that these variations were due to edge effects or residual confounding.
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