Maternal and community predictors of gastroschisis and congenital diaphragmatic hernia in Canada.

Abstract

The incidence of gastroschisis (GS) has increased globally. Maternal age and smoking are risk factors and aboriginal communities may be more commonly affected. Factors leading to this increased incidence are otherwise unclear. We investigate maternal sociodemography, air pollution and personal risk factors comparing mothers of infants with GS with a control group of infants with diaphragmatic hernia (CDH) in a large population-based analysis. Data were collected from a national, disease-specific pediatric surgical database (May 2006-June 2013). Maternal community sociodemographic information was derived from the Canadian 2006 Census. Univariate and multivariable analyses were performed examining maternal factors related to diagnosis of GS. GS infants come from poorer, less educated communities with more unemployment, less pollution, fewer immigrants, and more aboriginal peoples than infants with CDH. Teen maternal age, smoking, and illicit drug use, are associated with GS. Mothers of infants with GS are younger, more likely to smoke and come from socially disadvantaged communities with higher proportions of aboriginal peoples but lower levels of air pollution compared to mothers of CDH infants. Identification of maternal risks provides direction for prenatal screening and public health interventions.