Are Individual-Level Risk Factors for Gastroschisis Modified by Neighborhood-Level Socioeconomic Factors?

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Citation

Neo, Dayna T.; Martin, Chantel L.; Carmichael, Suzan L.; Gucsavas-Calikoglu, Muge; Conway, Kristin M.; Evans, Shannon P.; Feldkamp, Marcia L.; Gilboa, Suzanne M.; Insaf, Tabassum Z.; & Musfee, Fadi I., et al. (2023). Are Individual-Level Risk Factors for Gastroschisis Modified by Neighborhood-Level Socioeconomic Factors?. Birth Defects Research, 115(15), 1438-1449. PMCID: PMC10527855

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.

URL

http://dx.doi.org/10.1002/bdr2.2224

Reference Type

Journal Article

Year Published

2023

Journal Title

Birth Defects Research

Author(s)

Neo, Dayna T.
Martin, Chantel L.
Carmichael, Suzan L.
Gucsavas-Calikoglu, Muge
Conway, Kristin M.
Evans, Shannon P.
Feldkamp, Marcia L.
Gilboa, Suzanne M.
Insaf, Tabassum Z.
Musfee, Fadi I.
Shaw, Gary M.
Shumate, Charles J.
Werler, Martha M.
Olshan, Andrew F.
Desrosiers, Tania A.

Article Type

Regular

PMCID

PMC10527855

Data Set/Study

National Birth Defects Prevention Study (NBDPS)

Continent/Country

United States

State

Nonspecific

Sex/Gender

Women

ORCiD

Olshan - 0000-0001-9115-5128
Martin, C. - 0000-0003-1907-0810