Objective: To assess the association between genitourinary infections in the month before conception to the end of the first trimesterand gastroschisis.
Design: Case-control study with self reported infections from a computer assisted telephone interview.
Setting: National birth defects prevention study, a multisite, population based study including 10 surveillance systems for birth defects in the United States.
Participants: Mothers of 505 offspring with gastroschisis and 4924 healthy liveborn infants as controls.
Main outcome measure: Adjusted odds ratios for gastroschisis with 95% confidence intervals.
Results: About 16% (n=81) of case mothers and 9% (n=425) of control mothers reported a genitourinary infection in the relevant time period; 4% (n=21) and 2% (n=98) reported a sexually transmitted infection and 13% (n=67) and 7% (n=338) reported a urinary tract infection, respectively. Case mothers aged <25 years reported higher rates of urinary tract infection alone and in combination with a sexually transmitted infection compared with control mothers. In women who reported both types of infection, there was a greater risk of gastroschisis in offspring (adjusted odds ratio 4.0, 95% confidence interval 1.4 to 11.6).
Conclusion: There is a significant association between self reported urinary tract infection plus sexually transmitted infection just before conception and in early pregnancy and gastroschisis.