Associations between maternal characteristics and the prevalence of gastroschisis in Southern California

Background: Gastroschisis, a birth defect of the abdominal wall, has increased in incidence worldwide over the past several decades. While its pathogenesis remains unknown, studies implicate young maternal age, low maternal BMI, and nulliparity as risk factors. Methods: A retrospective chart review was performed on cases of gastroschisis in order to determine rates during a ­14 year time period in the Inland Empire Region of Southern California. Maternal factors of age, parity, and BMI were assessed to determine if longitudinal trends exist. The mean for each year was plotted, correlation models were generated to determine longitudinal changes in these risk factors, and scatter plot analysis was performed. GIS was used to determine if geographic clustering was present utilizing zip codes. Results: A line of best fit for maternal age shows R² =0.215 and a Pearson Coefficient =0.464 with a significance =0.082; a line of best fit for maternal parity shows R² =0.251 and a Pearson Coefficient =0.501 with a significance =0.057; and a line of best fit for maternal BMI over time shows R² =0.003 and a Pearson Coefficient =0.056 with a significance =0.843. Spatial analysis shows possible geographic clustering surrounding major transportation routes. Conclusion: An increase in maternal age and parity was seen over time, while BMI remained fairly constant. The results of this study allow us to recognize the changing risk factors for gastroschisis, leading to earlier prenatal diagnosis, improved clinical care, decreased morbidity associated with this disease, and offer the potential to reduce the health disparity.