Prevalence of gastroschisis, a birth defect where a baby’s intestines stick outside the body, is increasing in the United States. This birth defect can occur if the muscles in the baby’s abdominal wall do not form correctly in the womb, according to the US Centers for Disease Control and Prevention (CDC). Babies born with gastroschisis will undergo surgery to place the organs back into their bodies and repair the abdominal wall. After surgery, however, infants may experience problems related to feeding, digestion, and absorption of nutrients, the CDC noted. As a result, babies may be given nutrients intravenously and also receive antibiotics for infection.
Why are some babies born with gastroschisis? It may have something to do with a change in their genes or chromosomes, or the mother may have been exposed to something harmful in the environment during her pregnancy. Medications taken during pregnancy may also be related to gastroschisis, according to the CDC. While previous research found that gastroschisis incidence nearly doubled between 1995 and 2005 and that young maternal age was associated with the birth defect, a new report from the CDC expanded on those findings and suggested that the condition’s prevalence has increased for all maternal age groups. The new report examined data on gastroschisis from 14 population-based state surveillance programs and compared the condition’s prevalence in the period between 2006 and 2012 to the period between 1995 and 2005. Based on the CDC’s findings, here are 4 facts about gastroschisis that pharmacists should know:
1. African-American mothers younger than 20 years saw the greatest increase in babies with gastroschisis. While the prevalence of gastroschisis increased among all age groups and races/ethnicities from 1995 to 2012, the average annual percent change was greatest among African-American mothers younger than 20 years, at 263%. In contrast, white mothers’ average annual percent change in the same timeframe was 68%. 2. While African-Americans saw the greatest increase in gastroschisis incidence, white and Hispanic women were more likely to give birth to a baby with the condition. Between 2006 and 2012, the incidence of gastroschisis among white women younger than 20 years was 18.1 per 10,000 live births, while Hispanic mothers’ incidence was 16.1, and African-American mothers’ incidence was 10.2. 3. Total gastroschisis incidence has increased from 3.6 per 10,000 live births to 4.9 per 10,000 live births. Based on the researchers’ population data, there were around 12 million live births from 1995 to 2005, of which 4369 involved gastroschisis.
Between 2006 and 2012, there were 4497 gastroschisis cases among the 9 million live births. When comparing the 2 time periods, the researchers determined that the condition’s prevalence increased 30% in the time period of 2006 to 2012 compared with 1995 to 2005. 4. Previous research tackled some of the risk factors for gastroschisis after adjusting for maternal age. Research from 2008 found that some risk factors for gastroschisis may include lower socioeconomic status, lower body mass index, poor nutrition, smoking, illicit drugs, alcohol, analgesic medication use, and genitourinary infections.
There is also some evidence that a change in paternity from a previous pregnancy is linked with gastroschisis. “Gastroschisis is unusual among birth defects in that it disproportionately affects younger mothers—a vulnerable population,” the researchers stated. “The continued increase in age-adjusted prevalence and the pace of the increase suggests that unidentified risk factors might be contributing.” The researchers noted that the increasing prevalence of the gastroschisis could not be explained by demographic changes in maternal age or race. Teen births have been declining, and birth rates have decreased across all age groups. “Public health research is urgently needed to identify the causal factor(s) contributing to this increase,” the researchers concluded