Epidemiology of abdominal wall defects, Hawaii, 1986-1997

Abstract

The various types of abdominal wall defects are considered to differ in their etiologies, a hypothesis suggested by differences in their epidemiologies. This study examined the impact of selected demographic factors on abdominal wall defects (omphalocele, gastroschisis, and body stalk anomaly) included in a birth defects registry in Hawaii from 1986–1997. The total prevalence for the various defects were: omphalocele (2.76 per 10,000 births, 95% confidence interval (CI), 2.14–3.50), gastroschisis (3.01, 95% CI, 2.36–3.77), and body stalk anomalies (0.32, 95% CI, 0.14–0.64). The prevalence increased over the 12‐year period for both omphalocele (P = 0.052) and gastroschisis (P = 0.008). Women less than age 20 were at increased risk for a gastroschisis‐affected pregnancy, while those age 40 and over were disproportionately more likely to have an omphalocele‐affected pregnancy. Pacific Islanders had the lowest risk for omphalocele, whereas Far East Asians were least likely to have gastroschisis. Omphalocele rates were lower outside metropolitan Honolulu, while place of residence did not significantly impact gastroschisis risk. The 1‐year survival rate was higher for gastroschisis than for omphalocele (88.5% and 70.7%, respectively), while none of the infants with body stalk anomalies was live‐born. The results of this study tend to support the hypothesis of differing etiologies for the studied abdominal wall defects. Teratology 60:117–123, 1999. © 1999 Wiley‐Liss, Inc.

The Prognosis of Gastroschisis and Omphalocele

“…The prevalence of omphalocele has been reported to be 1.22-2.76 per 10,000 births, and gastroschisis, 0.94-3.01 per 10,000 births [3][4][5]. The exact etiology of these anomalies is unknown.…”

“…Therefore, the delivery and subsequent surgery can be planned and carried out in an interdisciplinary fashion. The mortality rate of omphalocele has been well known to be higher than that of gastroschisis [5,9,15,16]. Many studies demonstrated that this higher mortality was attributed to higher association of cardiac anomaly in omphalocele [17,18].…”

Maternal nativity as a risk factor for gastroschisis: A population‐based study

“…Much of the variation among states can be attributed to the method of case ascertainment and the case definition. States that use active case finding and that include cases from fetal deaths and live births, such as North Carolina (Laughon et al, 2003) and Hawaii (Forrester and Merz, 1999a), report relatively high prevalence rates (4.5 and 3.0/10,000 live births, respectively), while New York (Salihu et al, 2003), which uses passive case finding among live born infants, reports a relatively low rate (1.4/10,000).…”

“…The prevalence is also increasing in the United States, where the population-based rate of gastroschisis repairs was twofold higher in 2003 than 1996, with increases occurring in each census region (Alvarez and Burd, 2007). Utah (Hougland et al, 2005), Hawaii (Forrester and Merz, 1999a), New York (Salihu et al, 2003), Tennessee (Collins et al, 2007), California (Vu et al, 2008), and North Carolina (Laughon et al, 2003) reported increasing prevalence rates over the past decade.…”

Rising Birth Prevalence of Gastroschisis

“…8 The single investigation of this question in a statewide population of infants in the United States reported a modest increase between 1986 and 1997. 9 In this study, we sought to investigate changes in the birth prevalence of gastroschisis using data from a population-based state registry and data from a consortium of neonatal practices representing infants from across the United States.…”