The Relationship Between Socioeconomic Status and Omphalocele Prevalence

Abstract

Background: The omphalocele is a congenital malformation associated with chromosomal abnormalities, however the exact etiology is unknown. Current research has found maternal obesity, diabetes, and African American race as risk factors for omphalocele development and may point to a social determinant of health causative factor. Here we investigate the socioeconomic characteristics of patients with an omphalocele diagnosis and consider epigenetics as the facilitator in its manifestation.

Methods: This cross-sectional study used data from the 2019 National Kids' Inpatient Database to investigate patients with an omphalocele diagnosis, generating roughly 1400 data points where median household income (MHI), race, sex, and hospital region were investigated using chi-square analysis and held to a statistically significant p-value of <0.05.

Results: Chi-square analysis found a significant difference within MHI, race, sex, and region in omphalocele incidence. MHI quartiles were $1-47,999 (37 % of patients), $48,000-60,999 (23 %), $61,000-81,999 (22 %), and $82,000+ (18 %), Χ2 (3) = 24.973, p < 0.001. Reported race included White (51.2 %), Black (22.3 %), Hispanic (17.7 %), Asian/Pacific Islander (2.9 %), Native American (0.3 %), and other (5.6 %), Χ2 (5) = 34.739, p < 0.001. Males compromised 55.1 % of patients and Females 44.9 %, Χ2 (1) = 24.005, p < 0.001. Hospital region included the Northeast (15.0 %), Midwest (21.4 %), South (45.2 %), and West (18.4 %), Χ2 (3) = 26.379, p < 0.001.

Conclusions: This is the first study to show a lower MHI and Southern geographic region is associated with higher incidence of omphaloceles. Further research is necessary to determine the link between socioeconomic status and omphalocele development with epigenetics as the possible mechanism.

Level of evidence: Retrospective Study.

Level of evidence: III.

Keywords: Epigenetics; Median household income (MHI); Omphalocele; Socioeconomic status (SES).