Risk of gastroschisis with maternal genitourinary infections: the US National birth defects prevention study 1997–2011. Issue 3 (30th March 2019)

• Record Type: Journal Article
• Authors: Feldkamp, Marcia L; Arnold, Kathryn E; Krikov, Sergey; Reefhuis, Jennita; Almli, Lynn M; Moore, Cynthia A; Botto, Lorenzo D
• Is Part Of: BMJ open. Volume 9:Issue 3(2019)
• Publication Date: 2019-03-30
• Subjects: gastroschisis -- sexually transmitted disease -- urinary tract infections -- genitourinary tract infections -- Chlamydia trachomatis; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2018-026297
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: To assess the association between occurrence and timing of maternal self-reported genitourinary tract infection (urinary tract infections [UTIs] and/or sexually transmitted infection [STI]) and risk for gastroschisis in the offspring. Design: Population-based case–control study. Setting: National Birth Defects Prevention Study, a multisite study in the USA. Participants: Mothers of 1366 gastroschisis cases and 11 238 healthy controls. Main outcome measures: Crude and adjusted ORs (aORs) with 95% CIs. Results: Genitourinary infections were frequent in case (19.3%) and control women (9.9%) during the periconceptional period (defined as 3 months prior to 3 months after conception). UTI and/or STI in the periconceptional period were associated with similarly increased risks for gastroschisis (aOR 1.5, 95% CI 1.3 to 1.8; aOR 1.6, 95% CI 1.2 to 2.3, respectively). The risk was increased with a UTI before (aOR 2.5; 95% CI 1.4 to 4.5) or after (aOR 1.7; 95% CI 1.1 to 2.6) conception only among women ≥25 years of age. The risk was highest among women <20 years of age with an STI before conception (aOR 3.6; 95% CI 1.5 to 8.4) and in women ≥25 years of age, the risk was similar for before (aOR 2.9; 95% CI 1.0 to 8.5) and after (aOR 2.8; 95% CI 1.3 to 6.1) conception. A specific STI pathogen was reported in 89.3% (50/56) of cases and 84.3% (162/191) of controls with Chlamydia trachomatis the most common (25/50 cases, 50%; 58/162 controls, 36%) and highest among women <20 years of age (16/25 cases, 64%; 22/33 controls, 67%). Conclusions: UTI and/or STI were associated with an increased risk for gastroschisis, with the strength of the association varying by maternal age and timing of infection.