Are individual-level risk factors for gastroschisis modified by neighborhood-level socioeconomic factors?

Dayna T Neo; Chantel L Martin; Suzan L Carmichael; Muge Gucsavas-Calikoglu; Kristin M Conway; Shannon Pruitt Evans; Marcia L Feldkamp; Suzanne M Gilboa; Tabassum Z Insaf; Fadi I Musfee; Gary M Shaw; Charles Shumate; Martha M Werler; Andrew F Olshan; Tania A Desrosiers; National Birth Defects Prevention Study

doi:10.1002/bdr2.2224

Are individual-level risk factors for gastroschisis modified by neighborhood-level socioeconomic factors?

Birth Defects Res. 2023 Sep 1;115(15):1438-1449. doi: 10.1002/bdr2.2224. Epub 2023 Jul 13.

Authors

Dayna T Neo¹, Chantel L Martin^{1

2}, Suzan L Carmichael^{3

4}, Muge Gucsavas-Calikoglu⁵, Kristin M Conway⁶, Shannon Pruitt Evans^{7

8}, Marcia L Feldkamp⁹, Suzanne M Gilboa⁷, Tabassum Z Insaf^{10

11}, Fadi I Musfee^{12

13}, Gary M Shaw³, Charles Shumate¹⁴, Martha M Werler¹⁵, Andrew F Olshan¹, Tania A Desrosiers¹; National Birth Defects Prevention Study

Affiliations

¹ Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
² Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
³ Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA.
⁴ Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA.
⁵ Department of Pediatrics, Division of Genetics and Metabolism, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
⁶ Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
⁷ Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
⁸ Eagle Global Scientific LLC, San Antonio, Texas, USA.
⁹ Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
¹⁰ Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Albany, New York, USA.
¹¹ Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Rensselaer, New York, USA.
¹² Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
¹³ Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little, Arkansas, USA.
¹⁴ Texas Department of State Health Services, Birth Defects Epidemiology and Surveillance Branch, Austin, Texas, USA.
¹⁵ Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.

Abstract

Background: Two strong risk factors for gastroschisis are young maternal age (<20 years) and low/normal pre-pregnancy body mass index (BMI), yet the reasons remain unknown. We explored whether neighborhood-level socioeconomic position (nSEP) during pregnancy modified these associations.

Methods: We analyzed data from 1269 gastroschisis cases and 10,217 controls in the National Birth Defects Prevention Study (1997-2011). To characterize nSEP, we applied the neighborhood deprivation index and used generalized estimating equations to calculate odds ratios and relative excess risk due to interaction.

Results: Elevated odds of gastroschisis were consistently associated with young maternal age and low/normal BMI, regardless of nSEP. High-deprivation neighborhoods modified the association with young maternal age. Infants of young mothers in high-deprivation areas had lower odds of gastroschisis (adjusted odds ratio [aOR]: 3.1, 95% confidence interval [CI]: 2.6, 3.8) than young mothers in low-deprivation areas (aOR: 6.6; 95% CI: 4.6, 9.4). Mothers of low/normal BMI had approximately twice the odds of having an infant with gastroschisis compared to mothers with overweight/obese BMI, regardless of nSEP (aOR range: 1.5-2.3).

Conclusion: Our findings suggest nSEP modified the association between gastroschisis and maternal age, but not BMI. Further research could clarify whether the modification is due to unidentified biologic and/or non-biologic factors.

Keywords: BMI; age; birth defects; gastroschisis; neighborhood; socioeconomic.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Adult
Female
Gastroschisis* / complications
Gastroschisis* / etiology
Humans
Infant
Maternal Age
Mothers
Obesity / complications
Pregnancy
Risk Factors
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding