Analysis of gastroschisis case series for geographic clustering

Abstract

ALEXANDER FRIEDMAN, JENNIFER BALLARD DWAN, STEPHEN CARR, Brown University, Women & Infants’ Hospital of RI, Maternal-Fetal Medicine, Providence, Rhode Island OBJECTIVE: Clinical experience suggests a cluster of gastroschisis cases occurring in 2005. We aimed to determine if a geographic clustering of cases existed and to identify possible factors playing a role in gastroschisis cases. STUDY DESIGN: We performed a retrospective chart review of gastroschisis cases between 2001 and 2005. Women who delivered an infant with gastroschisis at Women and Infants’ Hospital during this period were identified using hospital discharge codes and records from our Prenatal Diagnostic Center. Each chart was reviewed for medical and demographic information including geographic location, smoking status, age, and race. RESULTS: 29 women living in Rhode Island were identified for inclusion in the study. Median age for the cohort was 23 years old (IQR 20-25). 43% of women reported using tobacco. 46% of cases were white, 36% were Latina, 11% were Asian, 3.5% were African-American, and 3.5% of other or unspecified race. Incidence of gastroschisis averaged 3.68/10,000 births in 2001-2004 and 6.67/10,000 births in 2005, an increase of 51% between 2004 and 2005. In 2005, 8 cases delivered within 4 months from 4 proximal zip codes. CONCLUSION: The temporal and geographic cluster of cases we experienced in 2005 suggests an environmental etiologic agent may play a role in the occurrence of gastroschisis. Rhode Island Department of Health is currently investigating possible etiologies for this cluster of cases.