Epidemiology of gastroschisis: A population-based study in California from 1995 to 2012

Although the incidence of gastroschisis is increasing, risk factors are not clearly identified.Using the Linked Birth Database from the California Office of Statewide Health Planning and Development from 1995 to 2012, patients with gastroschisis were identified by ICD-9 diagnosis/procedure code or birth certificate designation. Logistic regressions examined demographics, birth factors, and maternal exposures on risk of gastroschisis.The prevalence of gastroschisis was 2.7 cases per 10,000 live births. Patients with gastroschisis had no difference in fetal exposure to alcohol (p = 0.609), narcotics (p = 0.072), hallucinogenics (p = 0.239), or cocaine (p = 0.777), but had higher exposure to unspecified/other noxious substances (OR 3.27, p = 0.040; OR 2.02, p = 0.002). Gastroschisis was associated with low/very low birthweight (OR 5.08-16.21, p 0.001) and preterm birth (OR 3.26-10.0, p 0.001). Multivariable analysis showed lower risk in black (OR 0.44, p 0.001), Asian/Pacific Islander (OR 0.76, p = 0.003), and Hispanic patients (OR 0.72, p 0.001) compared to white patients. Risk was higher in rural areas (OR 1.24-1.76, p = 0.001). Compared to women age 20, risk decreased with advancing maternal age (OR 0.49-OR 0.03, p 0.001). Patients with gastroschisis had increased total charges ($336,270 vs. $9012, p 0.001) and length of stay (38.1 vs. 2.9 days, p 0.001). Mortality was 4.6%.This is the largest population-based study summarizing current epidemiology of gastroschisis in California.Retrospective comparative cohort study.III.