Is gastroschisis associated with county-level socio-environmental quality during pregnancy?

Alison K Krajewski; Achal Patel; Christine L Gray; Lynne C Messer; Corinna Y Keeler; Peter H Langlois; Jennita Reefhuis; Suzanne M Gilboa; Martha M Werler; Gary M Shaw; Suzan L Carmichael; Wendy N Nembhard; Tabassum Z Insaf; Marcia L Feldkamp; Kristin M Conway; Danelle T Lobdell; Tania A Desrosiers; National Birth Defects Prevention Study

doi:10.1002/bdr2.2250

Is gastroschisis associated with county-level socio-environmental quality during pregnancy?

Birth Defects Res. 2023 Nov 1;115(18):1758-1769. doi: 10.1002/bdr2.2250. Epub 2023 Sep 29.

Authors

Alison K Krajewski¹, Achal Patel², Christine L Gray³, Lynne C Messer⁴, Corinna Y Keeler², Peter H Langlois⁵, Jennita Reefhuis⁶, Suzanne M Gilboa⁶, Martha M Werler⁷, Gary M Shaw⁸, Suzan L Carmichael⁸, Wendy N Nembhard⁹, Tabassum Z Insaf^{10

11}, Marcia L Feldkamp¹², Kristin M Conway¹³, Danelle T Lobdell¹, Tania A Desrosiers²; National Birth Defects Prevention Study

Affiliations

¹ United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, Center for Public Health & Environmental Assessment, Research Triangle Park, North Carolina, USA.
² Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
³ Duke Global Health Institute, Durham, North Carolina, USA.
⁴ OHSU-PSU School of Public Health, Portland, Oregon, USA.
⁵ Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health-Austin Regional Campus, Austin, Texas, USA.
⁶ Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Infant Disorders, Atlanta, Georgia, USA.
⁷ Department of Epidemiology, Boston University, School of Public Health, Boston, Massachusetts, USA.
⁸ Stanford University, School of Medicine, Stanford, California, USA.
⁹ Department of Epidemiology, University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Little Rock, Arkansas, USA.
¹⁰ New York State Department of Health, Center for Environmental Health, Bureau of Environmental and Occupational Epidemiology, Albany, New York, USA.
¹¹ Department of Epidemiology and Biostatistics, University at Albany, Albany, New York, USA.
¹² Department of Pediatrics, Division of Medical Genetics, University of Utah, Salt Lake City, Utah, USA.
¹³ Department of Epidemiology, The University of Iowa, College of Public Health, Iowa City, Iowa, USA.

Abstract

Background: Gastroschisis prevalence more than doubled between 1995 and 2012. While there are individual-level risk factors (e.g., young maternal age, low body mass index), the impact of environmental exposures is not well understood.

Methods: We used the U.S. Environmental Protection Agency's Environmental Quality Index (EQI) as a county-level estimate of cumulative environmental exposures for five domains (air, water, land, sociodemographic, and built) and overall from 2006 to 2010. Adjusted odds ratios (aOR) and 95% confidence interval (CI) were estimated from logistic regression models between EQI tertiles (better environmental quality (reference); mid; poorer) and gastroschisis in the National Birth Defects Prevention Study from births delivered between 2006 and 2011. Our analysis included 594 cases with gastroschisis and 4105 infants without a birth defect (controls).

Results: Overall EQI was modestly associated with gastroschisis (aOR [95% CI]: 1.29 [0.98, 1.71]) for maternal residence in counties with poorer environmental quality, compared to the reference (better environmental quality). Within domain-specific indices, only the sociodemographic domain (aOR: 1.51 [0.99, 2.29]) was modestly associated with gastroschisis, when comparing poorer to better environmental quality.

Conclusions: Future work could elucidate pathway(s) by which components of the sociodemographic domain or possibly related psychosocial factors like chronic stress potentially contribute to risk of gastroschisis.

Keywords: EQI; environmental quality; environmental quality index; gastroschisis; sociodemographic.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Environmental Exposure / adverse effects
Female
Gastroschisis* / epidemiology
Gastroschisis* / etiology
Humans
Infant
Maternal Age
Odds Ratio
Pregnancy
Prevalence

Abstract

Publication types

MeSH terms

Grants and funding