Maternal Genitourinary Infections and the Risk of Gastroschisis

Yazdy, Mahsa M.; Mitchell, Allen A.; Werler, Martha M.

doi:10.1093/aje/kwu157

Cited by 27 publications

(40 citation statements)

References 41 publications

(39 reference statements)

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“…It is unclear whether the medication or the indication for medication is the risk factor in many studies of medication use. A previous study also observed an association between having a urinary tract infection and gastroschisis among younger mothers (Yazdy, Mitchell, & Werler, ) as we did, and another study observed a positive association between having a fever and gastroschisis (Waller et al, ) suggesting that further research into the joint effects of infection, medication use and indication, and maternal age may be warranted.…”

Section: Discussionsupporting

confidence: 83%

A machine learning approach to investigate potential risk factors for gastroschisis in California

Weber

Yang

Carmichael

et al. 2018

Birth Defects Research

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Background To generate new leads about risk factors for gastroschisis, a birth defect that has been increasing in prevalence over time, we performed an untargeted data mining statistical approach. Methods Using data exclusively from the California Center of the National Birth Defects Prevention Study, we compared 286 cases of gastroschisis and 1,263 non‐malformed, live‐born controls. All infants had delivery dates between October 1997 and December 2011 and were stratified by maternal age at birth (<20 and ≥ 20 years). Cases and controls were compared by maternal responses to 183 questions (219 variables) using random forest, a data mining procedure. Variables deemed important by random forest were included in logistic regression models to estimate odds ratios and 95% confidence intervals. Results Among women younger than 20, of variables deemed important, there were higher odds observed for higher consumption of chocolate, low intake of iron, acetaminophen use, and urinary tract infections during the beginning of pregnancy. After adjustment, the higher odds remained for low iron intake and a urinary tract infection in the first month of pregnancy. Among women aged 20 or older, of variables deemed important, higher odds were observed for US‐born women of Hispanic ethnicity and for parental substance abuse. There were lower odds observed for obese women, women who ate any cereal the month before pregnancy, and those with higher parity. Conclusions We did not discover many previously unreported associations, despite our novel approach to generate new hypotheses. However, our results do add evidence to some previously proposed risk factors.

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Section: Discussionsupporting

confidence: 83%

A machine learning approach to investigate potential risk factors for gastroschisis in California

Weber

Yang

Carmichael

et al. 2018

Birth Defects Research

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show abstract

“…While our findings across a number of other factors are in agreement with associations previously reported in the literature-namely with respect to parity [Feldkamp et al, 2008;Duong et al, 2012], education [Jenkins et al, 2014], rural versus urban residence [Salihu et al, 2003], smoking [Siega-Riz et al, 2009;Hackshaw et al, 2011;Khodr et al, 2013;Jenkins et al, 2014], drug abuse [Elliott et al, 2009], maternal nativity [Salemi et al, 2009], and infection [Feldkamp et al, 2008;Elliott et al, 2009;Ahrens et al, 2013;Yazdy et al, 2014]-our findings suggest that these risks may differ somewhat by age grouping. Like others [Salihu et al, 2003;Siega-Riz et al, 2009;Jenkins et al, 2014], before consideration of factors by age grouping, we found that Hispanic women were at increased risk of gastroschisis compared to non-Hispanic white women.…”

Section: Discussioncontrasting

confidence: 83%

“…While others have also observed a relationship between gastroschisis, sexually transmitted diseases, and urinary tract infections [Feldkamp et al, 2008;Elliott et al, 2009;Ahrens et al, 2013;Yazdy et al, 2014], our findings suggest an age-related pattern with respect to the importance of a particular type of infection. Of particular note with respect to age-related patterns is our observation regarding reported infection.…”

Section: Discussionmentioning

confidence: 99%

Maternal factors associated with the occurrence of gastroschisis

Baer

Chambers

Jones

et al. 2015

American J of Med Genetics Pt A

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We sought to identify age group specific maternal risk factors for gastroschisis. Maternal characteristics and prenatal factors were compared for 1,279 live born infants with gastroschisis and 3,069,678 without. Data were obtained using the California database containing linked hospital discharge, birth certificate and death records from 1 year prior to the birth to 1 year after the birth. Backwards-stepwise logistic regression models were used with maternal factors where initial inclusion was determined by a threshold of p < 0.10 on initial crude analyses. Due to the strong association of gastroschisis with young maternal age, models were stratified by age groups and odds ratios were calculated. These final models identified maternal infection as the only risk factor common to all age groups and a protective effect of obesity and gestational hypertension. In addition, age specific risk factors were identified. Although gestation at the time of infection was not available, a sexually transmitted disease complicating pregnancy was associated with increased risk in the less than 20 years of age grouping whereas viral infection was associated with increased risk only in the 20-24 and more than 24 years of age groupings. Urinary tract infection remained in the final logistic model for women less than 20 years. Short interpregnancy interval was not found to be a risk factor for any age group. Our findings support the need to explore maternal infection by type and gestational timing.

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“…However, in our study, some of the 1.3‐fold increased risk appeared to be due to confounding by HSV‐2 infection. Two other studies reported ORs of similar magnitude for self‐reported STDs during the first trimester in relation to gastroschisis although neither of these studies distinguished between specific types of STDs (Feldkamp et al, ; Yazdy et al, ).…”

Section: Discussionmentioning

confidence: 97%

Maternal Antibodies to Chlamydia trachomatis and Risk of Gastroschisis

Parker

Werler

Gissler

et al. 2017

Birth Defects Research

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Background Gastroschisis, a birth defect of the abdominal wall, is increasing in prevalence. The largest increase in prevalence has been observed among young mothers (<20 years). The prevalence of Chlamydia trachomatis (CT) infection is highest among young women and has also been increasing over time. The objective was to investigate the association between immunoglobulin G antibodies to Chlamydia trachomatis (CT) (anti-CT) and Chlamydial heat shock protein 60 (anti-CHP60) during pregnancy, and risk of gastroschisis among offspring. Methods We conducted a nested case–control study of 292 gastroschisis cases identified from the Congenital Malformations Register and 826 live born controls matched on age and birth year within the Finnish Maternity Cohort. Early pregnancy serum samples were used to categorize women by seropositivity to anti-CT and anti-CHP60. Women seronegative for anti-CT and anti-CHP60 served as the reference. We used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Effect measure modification by maternal age (<25 years, ≥25 years) was also assessed. Results Seropositivity to anti-CT (17.8% of cases vs. 16.0% of controls) or anti-CHP60 (23.6% of cases vs. 22.0% of controls) was not associated with gastroschisis. Although, the OR for seropositivity to anti-CT alone was slightly elevated (OR, 1.19; 95% CI, 0.73–1.94), specifically among young mothers (<25 years) (OR, 1.65; 95% CI, 0.81–3.37), the results were imprecise. Conclusion Chlamydia infection, as measured by immunoglobulin G antibodies to CT and CHP60, is not associated with gastroschisis, however, our assays were not able to distinguish recent infection.

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Maternal Genitourinary Infections and the Risk of Gastroschisis

Cited by 27 publications

References 41 publications

A machine learning approach to investigate potential risk factors for gastroschisis in California

A machine learning approach to investigate potential risk factors for gastroschisis in California

Maternal factors associated with the occurrence of gastroschisis

Maternal Antibodies to Chlamydia trachomatis and Risk of Gastroschisis

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