Joanne E Given1,2, Maria Loane2, Ester Garne3, Vera Nelen4, Ingeborg Barisic5, Hanitra Randrianaivo6, Babak Khoshnood7, Awi Wiesel8, Anke Rissmann9, Catherine Lynch10, Amanda J Neville11, Anna Pierini12, Marian Bakker13, Kari Klungsoyr14,15, Anna Latos Bielenska16, Clara Cavero-Carbonell17, Marie-Claude Addor18, Natalya Zymak-Zakutnya19, David Tucker20, Helen Dolk2. 1. Administrative Data Research Centre Northern Ireland, Ulster University, Newtownabbey, UK. 2. Institute of Nursing and Health Research, Ulster University, Newtownabbey, UK. 3. Paediatric Department, Hospital Lillebaelt, Kolding, Denmark. 4. Provinciaal Instituut voor Hygiene (PIH), Antwerp, Belgium. 5. Children's Hospital Zagreb, Medical School University of Zagreb, Zagreb, Croatia. 6. Registre des Malformations Congenitales de la Reunion, St Pierre, Ile de la Reunion. 7. Paris Registry of Congenital Anomalies, Maternité de Port-Royal, Paris, France. 8. Mainz Model Birth Registry, University Children's Hospital Mainz, Mainz, Germany. 9. Malformation Monitoring Centre Saxony-Anhalt, Otto-von-Guericke University Magdeburg, Magdeburg, Germany. 10. Department of Public Health, Health Service Executive - South East, Kilkenny, Ireland. 11. IMER Registry (Emilia Romagna Registry of Birth Defects), University of Ferrara and Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy. 12. Tuscany Registry of Congenital Defects, CNR Institute of Clinical Physiology/Fondazione Toscana "Gabriele Monasterio", Pisa, Italy. 13. Eurocat Northern Netherlands, University of Groningen, Groningen, The Netherlands. 14. Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway. 15. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. 16. Department of Medical Genetics, Polish Registry of Congenital Malformations, Poznan, Poland. 17. Rare Diseases Joint Research Unit, FISABIO-UVEG, Valencia, Spain. 18. Medical Genetics, CHUV, Lausanne, Switzerland. 19. OMNI-Net, Khmelnytsky Regional Medical Genetic Center, Khmelnytsky, Ukraine. 20. Congenital Anomaly Register and Information Service for Wales, Public Health Wales, Cardiff, UK.
Abstract
BACKGROUND: Gastroschisis, a congenital anomaly of the abdomen, is associated with young maternal age and has increased in prevalence in many countries. Maternal illness and medication exposure are among environmental risk factors implicated in its aetiology. METHODS: A population-based case-malformed control study was conducted using data from 18 European congenital anomaly registries, with information on first trimester medication use, covering 8 million births 1995-2012. 1577 gastroschisis cases (of which 4% stillbirths, 11% terminations of pregnancy) were compared to 153 357 non-chromosomal/monogenic controls. Literature review identified previous associations concerning maternal illness and medication exposure to be tested as signals. Logistic regression adjusted for maternal age group, registry, and time period was used to evaluate associations. RESULTS: Comparing gastroschisis to other congenital anomalies, the data supported signals concerning maternal depression (aOR 2.52, 95% CI 1.45, 4.39), antidepressant use (aOR 2.03, 95% CI 1.22, 3.38), postnatal depression/psychosis following a previous pregnancy (aOR 8.32, 95% CI 2.56, 27.01), sexually transmitted infections (aOR 2.85, 95% CI 1.13, 7.24), topical antivirals (aOR 5.31, 95% CI 1.63, 17.33), and continuation of oral contraceptives in early pregnancy (aOR 2.17, 95% CI 1.13, 4.18). Exploratory analyses suggested associations with a wider range of maternal infections and medications, including tonsillitis and the expectorant bromhexine. CONCLUSIONS: While it is difficult to disentangle the effects of the medication and underlying indication, our results add to the evidence base on preventable risk factors for gastroschisis. These risk factors may contribute to the higher risk among young mothers, and geographical and temporal variation in prevalence.
BACKGROUND: Gastroschisis, a congenital anomaly of the abdomen, is associated with young maternal age and has increased in prevalence in many countries. Maternal illness and medication exposure are among environmental risk factors implicated in its aetiology. METHODS: A population-based case-malformed control study was conducted using data from 18 European congenital anomaly registries, with information on first trimester medication use, covering 8 million births 1995-2012. 1577 gastroschisis cases (of which 4% stillbirths, 11% terminations of pregnancy) were compared to 153 357 non-chromosomal/monogenic controls. Literature review identified previous associations concerning maternal illness and medication exposure to be tested as signals. Logistic regression adjusted for maternal age group, registry, and time period was used to evaluate associations. RESULTS: Comparing gastroschisis to other congenital anomalies, the data supported signals concerning maternal depression (aOR 2.52, 95% CI 1.45, 4.39), antidepressant use (aOR 2.03, 95% CI 1.22, 3.38), postnatal depression/psychosis following a previous pregnancy (aOR 8.32, 95% CI 2.56, 27.01), sexually transmitted infections (aOR 2.85, 95% CI 1.13, 7.24), topical antivirals (aOR 5.31, 95% CI 1.63, 17.33), and continuation of oral contraceptives in early pregnancy (aOR 2.17, 95% CI 1.13, 4.18). Exploratory analyses suggested associations with a wider range of maternal infections and medications, including tonsillitis and the expectorant bromhexine. CONCLUSIONS: While it is difficult to disentangle the effects of the medication and underlying indication, our results add to the evidence base on preventable risk factors for gastroschisis. These risk factors may contribute to the higher risk among young mothers, and geographical and temporal variation in prevalence.
Authors: Robert Serunjogi; Linda Barlow-Mosha; Daniel Mumpe-Mwanja; Dhelia Williamson; Diana Valencia; Sarah C Tinker; Michelle R Adler; Joyce Namale-Matovu; Dennis Kalibbala; Jolly Nankunda; Evelyn Nabunya; Doreen Birabwa-Male; Josaphat Byamugisha; Philippa Musoke Journal: Reprod Health Date: 2021-03-04 Impact factor: 3.223
Authors: Meredith M Howley; Eleni A Papadopoulos; Carla M Van Bennekom; Alissa R Van Zutphen; Suzan L Carmichael; JeanPierre W Munsie; Michele L Herdt; Marilyn L Browne Journal: J Allergy Clin Immunol Pract Date: 2020-07-31
Authors: Nynke Spinder; Lynn M Almli; Tania A Desrosiers; Kathryn E Arnold; Jorieke E H Bergman; Hans Kromhout; H Marike Boezen; Hermien E K de Walle; Carissa Rocheleau; Jennita Reefhuis Journal: Occup Environ Med Date: 2020-01-16 Impact factor: 4.402