PDF(Pubmed)
Abstract：
BACKGROUND: Gastroschisis is a serious birth defect with midgut prolapse into the amniotic cavity. The objectives of this study were to evaluate the prevalence and time trends of gastroschisis among programs in the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR), focusing on regional variations and maternal age changes in the population.
METHODS: We analyzed data on births from 1980 to 2017 from 27 ICBDSR member programs, representing 24 countries and three regions (Europe+ (includes Iran) , Latin America, North America). Cases were identified using diagnostic codes (i.e., 756.7, 756.71, or Q79.3). We excluded cases of amniotic band syndrome, limb-body wall defect, and ruptured omphalocele. Programs provided annual counts for gastroschisis cases (live births, stillbirths, and legally permitted pregnancy terminations for fetal anomalies) and source population (live births, stillbirths), by maternal age.
RESULTS: Overall, gastroschisis occurred in 1 of every 3268 births (3.06 per 10,000 births; 95% confidence intervals [CI]: 3.01, 3.11), with marked regional variation. European+ prevalence was 1.49 (95%CI: 1.44, 1.55), Latin American 3.80 (95%CI: 3.69, 3.92) and North American 4.32 (95%CI: 4.22, 4.42). A statistically significant increasing time trend was observed among six European+ , four Latin American, and four North American programs. Women <20 years of age had the highest prevalence in all programs except the Slovak Republic.
CONCLUSIONS: Gastroschisis prevalence increased over time in 61% of participating programs, and the highest increase in prevalence was observed among the youngest women. Additional inquiry will help to assess the impact of the changing maternal age proportions in the birth population on gastroschisis prevalence.
METHODS: We analyzed data on births from 1980 to 2017 from 27 ICBDSR member programs, representing 24 countries and three regions (Europe+ (includes Iran) , Latin America, North America). Cases were identified using diagnostic codes (i.e., 756.7, 756.71, or Q79.3). We excluded cases of amniotic band syndrome, limb-body wall defect, and ruptured omphalocele. Programs provided annual counts for gastroschisis cases (live births, stillbirths, and legally permitted pregnancy terminations for fetal anomalies) and source population (live births, stillbirths), by maternal age.
RESULTS: Overall, gastroschisis occurred in 1 of every 3268 births (3.06 per 10,000 births; 95% confidence intervals [CI]: 3.01, 3.11), with marked regional variation. European+ prevalence was 1.49 (95%CI: 1.44, 1.55), Latin American 3.80 (95%CI: 3.69, 3.92) and North American 4.32 (95%CI: 4.22, 4.42). A statistically significant increasing time trend was observed among six European+ , four Latin American, and four North American programs. Women <20 years of age had the highest prevalence in all programs except the Slovak Republic.
CONCLUSIONS: Gastroschisis prevalence increased over time in 61% of participating programs, and the highest increase in prevalence was observed among the youngest women. Additional inquiry will help to assess the impact of the changing maternal age proportions in the birth population on gastroschisis prevalence.
摘要：
背景：胃裂是一种严重的出生缺陷，中肠脱出进入羊膜腔。这项研究的目的是评估国际出生缺陷监测和研究信息交换所（ICBDSR）计划中腹裂的患病率和时间趋势，重点关注人口的区域变化和孕产妇年龄变化。
方法：我们分析了来自27个ICBDSR成员计划的1980年至2017年出生数据，代表24个国家和三个地区(欧洲+(包括伊朗)，拉丁美洲,北美）。使用诊断代码识别病例(即，756.7、756.71或Q79.3）。我们排除了羊膜带综合征的病例，肢体壁缺损，和脐膨出破裂。计划提供了腹裂病例的年度计数(活产，死产,和法律允许的胎儿畸形终止妊娠)和来源人群(活产，死胎)，按产妇年龄。
结果：总体而言，腹裂发生在每3268例新生儿中的1例(每10,000例新生儿中有3.06例;95%置信区间[CI]:3.01,3.11),具有明显的区域差异。欧洲+患病率为1.49（95CI：1.44，1.55），拉丁美洲3.80（95CI：3.69，3.92）和北美4.32（95CI：4.22，4.42）。在六个欧洲+中观察到统计学上显著的时间增长趋势，四个拉丁美洲人，和四个北美项目。除斯洛伐克共和国外，20岁以下的妇女在所有方案中患病率最高。
结论：61％的参与项目中，随着时间的推移，胃裂患病率增加，在最年轻的女性中，患病率增长最高。进一步的调查将有助于评估出生人口中产妇年龄比例的变化对胃裂患病率的影响。
方法：我们分析了来自27个ICBDSR成员计划的1980年至2017年出生数据，代表24个国家和三个地区(欧洲+(包括伊朗)，拉丁美洲,北美）。使用诊断代码识别病例(即，756.7、756.71或Q79.3）。我们排除了羊膜带综合征的病例，肢体壁缺损，和脐膨出破裂。计划提供了腹裂病例的年度计数(活产，死产,和法律允许的胎儿畸形终止妊娠)和来源人群(活产，死胎)，按产妇年龄。
结果：总体而言，腹裂发生在每3268例新生儿中的1例(每10,000例新生儿中有3.06例;95%置信区间[CI]:3.01,3.11),具有明显的区域差异。欧洲+患病率为1.49（95CI：1.44，1.55），拉丁美洲3.80（95CI：3.69，3.92）和北美4.32（95CI：4.22，4.42）。在六个欧洲+中观察到统计学上显著的时间增长趋势，四个拉丁美洲人，和四个北美项目。除斯洛伐克共和国外，20岁以下的妇女在所有方案中患病率最高。
结论：61％的参与项目中，随着时间的推移，胃裂患病率增加，在最年轻的女性中，患病率增长最高。进一步的调查将有助于评估出生人口中产妇年龄比例的变化对胃裂患病率的影响。
