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. 2015 Jun;103(6):544-53.
doi: 10.1002/bdra.23375. Epub 2015 Apr 6.

Spatial analysis of gastroschisis in the National Birth Defects Prevention Study

Mahsa M Yazdy  1 , Martha M Werler  1 , Marcia L Feldkamp  2 , Gary M Shaw  3 , Bridget S Mosley  4 , Veronica M Vieira  5 ; National Birth Defects Prevention Study
Affiliations

Spatial analysis of gastroschisis in the National Birth Defects Prevention Study

Mahsa M Yazdy et al. Birth Defects Res A Clin Mol Teratol. 2015 Jun.

Abstract

Background: Gastroschisis is a birth defect where loops of bowel are protruding from the abdominal wall at birth. Previous research has suggested that gastroschisis cases can occur in clusters. The objective of this study was to identify if there were areas of elevated gastroschisis risk using data from the National Birth Defects Prevention Study (NBDPS), 1997 through 2007.

Methods: We obtained data on cases (n = 371) through population-based birth defects surveillance systems in Arkansas, California, and Utah; controls (n = 2359) were selected from the same geographic areas as cases. Mothers were interviewed on demographic information and exposures during pregnancy, including residential history. We used first trimester maternal addresses and generalized additive models to create a continuous map surface of odds ratios (OR) by smoothing over latitude and longitude. Permutation tests were used to assess whether location of maternal residence was important and identify locations with statistically significant ORs.

Results: In Arkansas, adjusted ORs in the southwest corner were 2.0 and the global deviance was not statistically significant (p-value: 0.57). Adjusted ORs for California indicated areas of increased risk with ORs 1.3 (p-value: 0.34). In Utah, the adjusted ORs were elevated (OR: 2.4) in the south-eastern corner of the study area (p-value: 0.34).

Conclusion: The results of this study, while not statistically significant, suggest there were spatial variations in gastroschisis births. We cannot rule out that these variations were due to edge effects or residual confounding.

Keywords: congenital abnormalities; gastroschisis; spatial analysis.

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Figures

Figure 1
Figure 1
Distribution of cases and controls (A); map of crude (B) and adjusted odds ratio (C); and map of sensitivity analysis including mothers with missing geocodes (D) in Arkansas, National Birth Defects Prevention Study, 1997—2007.
Figure 2
Figure 2
Distribution of cases and controls (A); map of crude (B) and adjusted odds ratio (C); and map of sensitivity analysis including mothers with missing geocodes (D) in California, National Birth Defects Prevention Study, 1997—2007.
Figure 3
Figure 3
Distribution of cases and controls (A); map of crude (B) and adjusted odds ratio (C); and map of sensitivity analysis including mothers with missing geocodes (D) in Utah, National Birth Defects Prevention Study, 2003—2007.
See this image and copyright information in PMC

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