Continued increase in birth defect of abdominal wall

Largest increase among young black mothers

Cases of a serious birth defect of the abdominal wall called gastroschisis continues to increase over time, according to a report in CDC’s Morbidity and Mortality Weekly Report. CDC researchers found that over 18 years, the prevalence of gastroschisis more than doubled in the United States. More research is needed to understand what is causing the increase.

Gastroschisis was most prevalent among mothers younger than 20 years of age. The largest increase in this birth defect – 263 percent from 1995 to 2012 – was among babies born to non-Hispanic black mothers age 20 or younger.

“It concerns us that we don’t know why more babies are being born with this serious birth defect. Public health research is urgently needed to figure out the cause and why certain women are at higher risk of having a baby born with gastroschisis,” said Coleen Boyle, Ph.D., director of CDC’s National Center on Birth Defects and Developmental Disabilities.

Babies with gastroschisis are born with their intestines extruding from their body through an opening in the abdominal wall. Sometimes other organs, such as the stomach and liver, may also be involved. This birth defect requires surgery to return the abdominal organs into the baby’s body and repair the abdominal wall. Even after surgery, infants with gastroschisis can have problems eating or digesting food. In some cases, gastroschisis can be life threatening. Overall, about 2,000 U.S. babies are born each year with gastroschisis.

The CDC study analyzed data from 14 states: Arizona, Arkansas, California, Colorado, Georgia, Iowa, Kentucky, New Mexico, New York, North Carolina, Oklahoma, Rhode Island, Texas, and Utah. The study compared the prevalence of gastroschisis among babies born to mothers of different ages in 1995-2005 to those born in 2006-2012.

In addition to the finding that the largest increase in gastroschisis was among black non-Hispanic teen mothers, CDC researchers found that:

• Most cases of gastroschisis occurred in mothers younger than age 20 years;
• The increase in gastroschisis births among teen mothers is not related to the number of live births for teen mothers, which actually declined during the same period.
• From 1995-2012, the number of babies born with gastroschisis increased among mothers of every age and racial/ethnic group studied;

“While gastroschisis has become more common among non-Hispanic white and Hispanic mothers, this study shows the greatest increases were among younger, non-Hispanic black mothers. We must continue to monitor changes in this birth defect to identify risk factors contributing to these increases and hopefully start to reverse the trend,” said Peggy Honein, Ph.D., M.P.H., chief, Birth Defects Branch, CDC National Center on Birth Defects and Developmental Disabilities.

CDC is working to address birth defects, including gastroschisis, through the following activities:

• Tracking: CDC tracks birth defects through several state tracking systems and regional programs. CDC also supports and collaborates with the National Birth Defects Prevention Network (NBDPN).
• Research: CDC funds the Centers for Birth Defects Research and Prevention, which collaborate on large studies such as the National Birth Defects Prevention Study (births 1997-2011) and the Birth Defects Study to Evaluate Pregnancy exposures (BD-STEPS) (began with births in 2014). These studies work to identify factors that increase the risk for birth defects.

For more information about gastroschisis, visit www.cdc.gov/ncbddd/birthdefects/Gastroschisis.html.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES