Risk factors for abdominal wall defects

Abstract

In the last decades, the prevalence of gastroschisis (GS) has increased worldwide. The purpose of this study was to identify maternal risk factors explaining the described gain and to identify differences between GS and omphalocele (OC). A case‐control design was used to compare GS (n = 36) and OC (n = 18) mothers to control group (CG; n = 30) matched for maternal age. Specialized questionnaires and mothers' prenatal records were used, and participants completed a structured interview. Focus was on medical history, changing nutrition, drug consumption, and external risk factors. The local ethics committee approved this study. GS mothers were significantly younger (mean 23.00; median 24; SD ±5) than OC (P = 0.007; mean 28.61; median 28, 19‐41; SD ±5.1) and CG (P = 0.001; mean 30.77; median 31, SD ±6.2). Mothers with abdominal wall defects (AWD) ingested antibiotics more often (P = 0.008) than CG. Socioeconomic characteristics, for example, level of profession, of GS mothers was significantly lower than OC (P = 0.039) and CG (P = 0.05) mothers, and their cohabitation time was shorter (P < 0.05; mean 35 month/median 24 month, SD ±35.8). Incidence of OC significantly increased after hormonal treatment (P = 0.022) and invasive prenatal diagnostics (P < 0.05) compared to GS. GS mothers took folic acid prophylaxis less often than OC (P = 0.02). Smoking, illicit drugs, and external risks like herbicides showed no influence, but GS mothers drink significantly more often alcohol (P = 0.05). We confirmed an increased risk for GS if several factors such as young maternal age, short cohabitation time, and usage of antibiotics coincide with alcohol consumption and associated immune diseases. OC increased after hormonal treatment and invasive prenatal diagnostics.

Risk factors for anorectal and associated malformations in German children: A 10-year analysis

“…The background for this age-related ARM development is unclear. Advanced paternal age may be ; younger maternal age is known to be associated to congenital defects of the abdominal wall, 12 and therefore a combination of both could increase the risk for congenital malformations like ARM. Contrary to the latest studies, we did not find an increased risk of ARM following sterility treatment, hormone intake or in-vitro fertilization.…”

Extended spectrum penicillins reduce the risk of omphalocele: A population-based case-control study

“…However, there are only few studies on the effects of maternal medication on the risk of omphalocele. [24][25][26][27] The aim of this study was to assess and identify potential maternal risk factors of omphalocele, and especially to assess the safety and effects of the medications used during the first trimester of pregnancy. We hypothesized that maternal exposures during the first trimester of pregnancy would affect the risk of omphalocele.…”

Rare association of exomphalos and maternal alcohol use

“…46% of the mothers affected by an omphalocele reported alcohol intake in the pregnancy in this cohort [6]. Interestingly, smoking has no statistically significant influence on the incidence of omphalocele [5].…”

“…Fetal alcohol spectrum disorders are characterized by specific craniofacial anomalies, neurodevelopmental disorders, growth restriction, and cardiac anomalies, but traditionally not omphalocele. A retrospective observational study of 27,438 births at a German University hospital showed that none of the 18 cases of omphalocele over an 11-year period was associated with maternal alcohol [5]. However in the National Birth Defect Prevention Study undertaken across multiple US centers, the adjusted Odd Ratio between periconceptional maternal alcohol consumption and the 254 cases of chromosomally normal and non-syndromic omphalocele was 1.50 (CI 1.15-1.96).…”