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Parata G, Vial Y, Addor MC, Pellegrinelli JM, Wildhaber BE. Anatomic parameters of omphaloceles and their association with anatomic, genetic, or syndromic malformations: a retrospective study. Pediatr Surg Int 2024; 40:136. [PMID: 38780818 PMCID: PMC11116210 DOI: 10.1007/s00383-024-05717-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE This retrospective study aims to describe anatomical parameters of omphaloceles and to analyze their association with anatomical, genetic, or syndromic malformations. METHODS Cases were selected from digital records of two university centers, a certified regional registry and personal records. Patients from 1998 to 2018 with omphalocele and live birth (LB), termination of pregnancy due to fetal anomaly (TOPFA) and fetal death (FD) were included. Cases born outside Western Switzerland and/or with upper or lower coelosomy were excluded. RESULTS We analyzed 162 cases with the following distribution: 57 (35%) LB, 91 (56%) TOPFA and 14 (9%) FD. TOPFA was significantly more frequently performed in cases with non-isolated omphalocele, i.e., omphaloceles with associated major malformations (especially cardiovascular and genitourinary), genetic/chromosomal anomalies, or syndromes. For LB, associated anatomical malformations, genetic or chromosomal anomalies were not significantly associated with the size of the omphalocele or the liver involvement. CONCLUSIONS The proportion of cases resulting in TOPFA was higher among fetuses with major malformations, genetic or chromosomal anomalies. Despite the large size of this cohort, and in contrary to previous publications, the size of the omphalocele and/or liver involvement does not allow for conclusions regarding the presence or number of associated malformations, genetic or chromosomal anomalies.
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Affiliation(s)
- Gallien Parata
- Service médico-chirurgical de pédiatrie, Hôpital du Valais, Sion, Switzerland
| | - Yvan Vial
- Service of Obstetrics, Department of Woman-Mother-Child, University Medical Centre CHUV, Lausanne, Switzerland
| | - Marie-Claude Addor
- Service of Genetics, Department of Woman-Mother-Child, University Medical Centre CHUV, Lausanne, Switzerland
| | - Jean-Marie Pellegrinelli
- Division of Obstetrics, Department of Pediatrics, Gynecology, and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
| | - Barbara E Wildhaber
- Division of Child and Adolescent Surgery, Department of Pediatrics, Gynecology, and Obstetrics, Geneva University Hospitals, University of Geneva, 6, Rue Willy Donzé, 1205, Geneva, Switzerland.
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Raitio A, Tauriainen A, Leinonen MK, Syvänen J, Kemppainen T, Löyttyniemi E, Sankilampi U, Gissler M, Hyvärinen A, Helenius I. Extended spectrum penicillins reduce the risk of omphalocele: A population-based case-control study. J Pediatr Surg 2021; 56:1590-1595. [PMID: 33250216 DOI: 10.1016/j.jpedsurg.2020.10.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/29/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Omphalocele is a major congenital anomaly associated with significant morbidity and mortality. Regardless, the influence of maternal use of prescription drugs on the risk of omphalocele has only been addressed in a handful of studies. The aim of this study was to assess the influence of maternal risk factors and prescription drugs in early pregnancy on the risk of omphalocele. METHODS We performed a nationwide register-based case-control study in Finland. The analysis is based on the Finnish Register of Congenital Malformations and Drugs and Pregnancy databases, both upheld by the Finnish Institute for Health and Welfare. All omphalocele cases were identified between Jan 1, 2004, and Dec 31, 2014. Five age-matched controls from the same geographical region were randomly selected for each case. The main outcome measures were maternal risk factors for omphalocele. Our analysis compared the maternal characteristics and the use of prescription drugs during the first trimester of pregnancy between case and control mothers. RESULTS Mothers of 359 omphalocele cases were compared with 1738 randomly selected age and area-matched mothers of healthy infants between 1 January 2014 and 31 December 2014. Both maternal obesity (BMI ≥30) and diabetes increased the risk for omphalocele, and their co-occurrence accumulated this risk (aOR 5.06, 95% Cl 1.19-21.4). Similarly, history of multiple miscarriages was an independent risk factor (2.51, 1.16-5.43). The oral use of extended spectrum penicillins during the first trimester of pregnancy had a significant, protective influence (0.17, 0.04-0.71). These analyses were adjusted for sex, parity, and risk factors reported above. No significant changes in risk were observed with any other medication used during the first trimester. CONCLUSION In conclusion, these findings may suggest that extended spectrum penicillins in the first trimester reduces the risk of omphalocle formation. Additionally, consistent with earlier studies, previous repeated miscarriages, maternal obesity, and diabetes were significant risk factors for omphalocele.
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Affiliation(s)
- Arimatias Raitio
- Department of Paediatric Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, PL 52, 20521, Turku, Finland.
| | - Asta Tauriainen
- Department of Paediatric Surgery, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Maarit K Leinonen
- Information Services Department, Finnish Institute for Health and Welfare, Mannerheimintie 166, PL 30, 00271 Helsinki, Finland
| | - Johanna Syvänen
- Department of Paediatric Surgery, University of Turku and Turku University Hospital, Kiinamyllynkatu 4-8, PL 52, 20521, Turku, Finland
| | - Teemu Kemppainen
- Department of Biostatistics, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Eliisa Löyttyniemi
- Department of Biostatistics, University of Turku and Turku University Hospital, Kiinamyllynkatu 10, 20520, Turku, Finland
| | - Ulla Sankilampi
- Department of Paediatrics, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Mika Gissler
- Information Services Department, Finnish Institute for Health and Welfare, Mannerheimintie 166, PL 30, 00271 Helsinki, Finland; Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Solnavägen 1, 17177, Solna, Sweden
| | - Anna Hyvärinen
- Department of Paediatric Surgery, Tampere University Hospital and Tampere University, Elämänaukio, Kuntokatu 2, 33520, Tampere, Finland
| | - Ilkka Helenius
- Department of Orthopaedics and Traumatology, Helsinki University Hospital and University of Helsinki, Finland
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3
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Nembhard WN, Bergman JEH, Politis MD, Arteaga-Vázquez J, Bermejo-Sánchez E, Canfield MA, Cragan JD, Dastgiri S, de Walle HEK, Feldkamp ML, Nance A, Gatt M, Groisman B, Hurtado-Villa P, Kallén K, Landau D, Lelong N, Lopez-Camelo J, Martinez L, Morgan M, Pierini A, Rissmann A, Šípek A, Szabova E, Tagliabue G, Wertelecki W, Zarante I, Bakker MK, Kancherla V, Mastroiacovo P. A multi-country study of prevalence and early childhood mortality among children with omphalocele. Birth Defects Res 2020; 112:1787-1801. [PMID: 33067932 DOI: 10.1002/bdr2.1822] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Omphalocele is the second most common abdominal birth defect and often occurs with other structural and genetic defects. The objective of this study was to determine omphalocele prevalence, time trends, and mortality during early childhood, by geographical region, and the presence of associated anomalies. METHODS We conducted a retrospective study with 23 birth defect surveillance systems in 18 countries who are members of the International Clearinghouse for Birth Defects Surveillance and Research that submitted data on cases ascertained from 2000 through 2012, approximately 16 million pregnancies were surveyed that resulted in live births, stillbirths, or elective terminations of pregnancy for fetal anomalies (ETOPFA) and cases with omphalocele were included. Overall prevalence and mortality rates for specific ages were calculated (day of birth, neonatal, infant, and early childhood). We used Kaplan-Meier estimates with 95% confidence intervals (CI) to calculate cumulative mortality and joinpoint regression for time trend analyses. RESULTS The prevalence of omphalocele was 2.6 per 10,000 births (95% CI: 2.5, 2.7) and showed no temporal change from 2000-2012 (average annual percent change = -0.19%, p = .52). The overall mortality rate was 32.1% (95% CI: 30.2, 34.0). Most deaths occurred during the neonatal period and among children with multiple anomalies or syndromic omphalocele. Prevalence and mortality varied by registry type (e.g., hospital- vs. population-based) and inclusion or exclusion of ETOPFA. CONCLUSIONS The prevalence of omphalocele showed no temporal change from 2000-2012. Approximately one-third of children with omphalocele did not survive early childhood with most deaths occurring in the neonatal period.
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Affiliation(s)
- Wendy N Nembhard
- Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Little Rock, Arkansas, USA.,Arkansas Reproductive Health Monitoring System, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Jorieke E H Bergman
- Department of Genetics, EUROCAT Northern Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Maria D Politis
- Arkansas Center for Birth Defects Research and Prevention, Fay W. Boozman College of Public Health, Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jazmín Arteaga-Vázquez
- RYVEMCE (Mexican Registry and Epidemiological Surveillance of Congenital Malformations), Department of Genetics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Eva Bermejo-Sánchez
- ECEMC (Spanish Collaborative Study of Congenital Malformations) and ECEMC's Clinical Network, Research Unit on Congenital Anomalies, Institute of Rare Diseases Research (IIER), Instituto de Salud Carlos III, Madrid, Spain
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA
| | - Janet D Cragan
- Metropolitan Atlanta Congenital Defects Program, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Saeed Dastgiri
- Health Services Management Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hermien E K de Walle
- Department of Genetics, EUROCAT Northern Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marcia L Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Amy Nance
- Utah Birth Defect Network, Bureau of Children with Special Health Care Needs, Division of Family Health and Preparedness, Utah Department of Health, Salt Lake City, Utah, USA
| | - Miriam Gatt
- Malta Congenital Anomalies Registry, Directorate for Health Information and Research, Valletta, Malta
| | - Boris Groisman
- National Network of Congenital Anomalies of Argentina (RENAC), National Center of Medical Genetics, National Administration of Laboratories and Health Institutes, National Ministry of Health and Social Development, Buenos Aires, Argentina
| | - Paula Hurtado-Villa
- Department of Basic Sciences of Health, School of Health, Pontificia Universidad Javeriana Cali, Cali, Colombia
| | - Kärin Kallén
- National Board of Health and Welfare, Stockholm, Sweden
| | - Danielle Landau
- Department of Neonatology, Soroka Medical Center, Beer-Sheva, Israel
| | - Nathalie Lelong
- REMAPAR, Paris Registry of Congenital Malformations, Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Jorge Lopez-Camelo
- ECLAMC, Center for Medical Education and Clinical Research (CEMIC-CONICET), Buenos Aires, Argentina
| | - Laura Martinez
- Genetics Department, Hospital Universitario Dr Jose E. Gonzalez, Universidad Autonóma de Nuevo León, Nuevo León, Mexico
| | - Margery Morgan
- The Congenital Anomaly Register and Information Service for Wales, Singleton Hospital, Swansea, Wales, UK
| | - Anna Pierini
- Institute of Clinical Physiology, National Research Council/Fondazione Toscana Gabriele Monasterio, Tuscany Registry of Congenital Defects, Pisa, Italy
| | - Anke Rissmann
- Malformation Monitoring Centre Saxony-Anhalt, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
| | - Antonin Šípek
- Department of Medical Genetics, Thomayer Hospital, Prague, Czech Republic
| | - Elena Szabova
- Slovak Teratologic Information Centre (FPH), Slovak Medical University, Bratislava, Slovakia
| | - Giovanna Tagliabue
- Lombardy Congenital Anomalies Registry, Cancer Registry Unit, Fondazione IRCCS, Istituto Nazionale dei tumori, Milan, Italy
| | | | - Ignacio Zarante
- Human Genetics Institute, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Marian K Bakker
- Department of Genetics, EUROCAT Northern Netherlands, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Vijaya Kancherla
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Pierpaolo Mastroiacovo
- International Center on Birth Defects, International Clearinghouse for Birth Defects Surveillance and Research, Rome, Italy
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Mesas Burgos C, Frenckner B, Harting MT, Lally PA, Lally KP. Congenital diaphragmatic hernia and associated omphalocele: a study from the CDHSG registry. J Pediatr Surg 2020; 55:2099-2104. [PMID: 31870561 DOI: 10.1016/j.jpedsurg.2019.10.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/08/2019] [Accepted: 10/16/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Congenital Diaphragmatic Hernia (CDH) associated with Omphalocele is a rare condition, and only a few case reports are available in the literature. Both conditions are associated with some degree of pulmonary hypoplasia. We hypothesize that the combination of CDH with Omphalocele might be associated with poorer outcomes. AIM The aim of this study was to describe the incidence of this association and postnatal outcomes from the largest database available for CDH. METHODS Data from the multicenter, multinational database on infants with CDH (CDHSG Registry) born from 2007 to 2018 was analyzed. RESULTS A total of 5730 entries were made into the registry during the study period. The incidence of Omphalocele associated with CDH was 0.63% (36 out of 5730). When comparing posterolateral Bochdalek hernias with Omphalocele (CDH + O) to CDH without Omphalocele (CDH-), CDH + O were born at significantly younger gestational ages. They were sicker directly after birth with significantly lower APGARs at all time points, but received ECMO significantly less often. The distribution of left vs right side or the defect size did not differ but CDH + O required patch in a significantly larger extent. CDH + O had surgical repair significantly later and had significantly higher rates of non-repairs and significantly lower survival rates. The morbidity was significantly higher with longer hospital stays and higher requirements for O2 at 30 DOL. DISCUSSION CDH associated with Omphalocele is a rare but more severe condition with higher mortality and morbidity rates. Newborns with these combined conditions can be difficult to stabilize or might pose complicated management problems due to pulmonary hypertension and/or pulmonary hypoplasia. TYPE OF STUDY Prognosis Study. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
| | - Björn Frenckner
- Department of Pediatric Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Matthew T Harting
- Department of Pediatric Surgery, McGovern Medical School at UT Health and Children's Memorial Hermann Hospital, Houston, TX, USA
| | - Pamela A Lally
- Department of Pediatric Surgery, McGovern Medical School at UT Health and Children's Memorial Hermann Hospital, Houston, TX, USA
| | - Kevin P Lally
- Department of Pediatric Surgery, McGovern Medical School at UT Health and Children's Memorial Hermann Hospital, Houston, TX, USA
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Stallings EB, Isenburg JL, Short TD, Heinke D, Kirby RS, Romitti PA, Canfield MA, O'Leary LA, Liberman RF, Forestieri NE, Nembhard WN, Sandidge T, Nestoridi E, Salemi JL, Nance AE, Duckett K, Ramirez GM, Shan X, Shi J, Lupo PJ. Population-based birth defects data in the United States, 2012-2016: A focus on abdominal wall defects. Birth Defects Res 2019; 111:1436-1447. [PMID: 31642616 DOI: 10.1002/bdr2.1607] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/OBJECTIVES In this report, the National Birth Defects Prevention Network (NBDPN) examines and compares gastroschisis and omphalocele for a recent 5-year birth cohort using data from 30 population-based birth defect surveillance programs in the United States. METHODS As a special call for data for the 2019 NBDPN Annual Report, state programs reported expanded data on gastroschisis and omphalocele for birth years 2012-2016. We estimated the overall prevalence (per 10,000 live births) and 95% confidence intervals (CI) for each defect as well as by maternal race/ethnicity, maternal age, infant sex, and case ascertainment methodology utilized by the program (active vs. passive). We also compared distribution of cases by maternal and infant factors and presence/absence of other birth defects. RESULTS The overall prevalence estimates (per 10,000 live births) were 4.3 (95% CI: 4.1-4.4) for gastroschisis and 2.1 (95% CI: 2.0-2.2) for omphalocele. Gastroschisis was more frequent among young mothers (<25 years) and omphalocele more common among older mothers (>40 years). Mothers of infants with gastroschisis were more likely to be underweight/normal weight prior to pregnancy and mothers of infants with omphalocele more likely to be overweight/obese. Omphalocele was twice as likely as gastroschisis to co-occur with other birth defects. CONCLUSIONS This report highlights important differences between gastroschisis and omphalocele. These differences indicate the importance of distinguishing between these defects in epidemiologic assessments. The report also provides additional data on co-occurrence of gastroschisis and omphalocele with other birth defects. This information can provide a basis for future research to better understand these defects.
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Affiliation(s)
- Erin B Stallings
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, Georgia.,Carter Consulting, Incorporated, Atlanta, Georgia
| | - Jennifer L Isenburg
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, Georgia
| | - Tyiesha D Short
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, Georgia.,Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Dominique Heinke
- Massachusetts Department of Public Health, Center for Birth Defects Research and Prevention, Boston, Massachusetts
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, Florida
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Mark A Canfield
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas
| | - Leslie A O'Leary
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, Georgia
| | - Rebecca F Liberman
- Massachusetts Department of Public Health, Center for Birth Defects Research and Prevention, Boston, Massachusetts
| | - Nina E Forestieri
- Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina
| | - Wendy N Nembhard
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Arkansas Center for Birth Defects Research and Prevention, Little Rock, Arkansas
| | | | - Eirini Nestoridi
- Massachusetts Department of Public Health, Center for Birth Defects Research and Prevention, Boston, Massachusetts
| | - Jason L Salemi
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas
| | - Amy E Nance
- Utah Birth Defect Network, Division of Family Health and Preparedness, Utah Department of Health, Salt Lake City, Utah
| | | | - Glenda M Ramirez
- Arizona Birth Defects Monitoring Program, Arizona Department of Health Services, Phoenix, Arizona
| | - Xiaoyi Shan
- Arkansas Reproductive Health Monitoring System, Arkansas Children's Research Institute, Little Rock, Arkansas
| | - Jing Shi
- Special Child Health and Early Intervention Services, New Jersey Department of Health, Trenton, New Jersey
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, Texas
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Salinas-Torres VM, Salinas-Torres RA, Cerda-Flores RM, Gallardo-Blanco HL, Martínez-de-Villarreal LE. A clinical-pathogenetic approach on associated anomalies and chromosomal defects supports novel candidate critical regions and genes for gastroschisis. Pediatr Surg Int 2018; 34:931-943. [PMID: 30094464 DOI: 10.1007/s00383-018-4331-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gastroschisis has been assumed to have a low rate of syndromic and primary malformations. We aimed to systematically review and explore the frequency and type of malformations/chromosomal syndromes and to identify significant biological/genetic roles in gastroschisis. METHODS Population-based, gastroschisis-associated anomalies/chromosomal defects published 1950-2018 (PubMed/MEDLINE) were independently searched by two reviewers. Associated anomalies/chromosomal defects and selected clinical characteristics were subdivided and pooled by race, system/region, isolated, and associated cases (descriptive analysis and chi-square test were performed). Critical regions/genes from representative chromosomal syndromes including an enrichment analysis using Gene Ontology Consortium/Panther Classification System databases were explored. Fisher's exact test with False Discovery Rate multiple test correction was performed. RESULTS Sixty-eight articles and 18525 cases as a base were identified (prevalence of 17.9 and 3% for associated anomalies/chromosomal defects, respectively). There were 3596 associated anomalies, prevailing those cardiovascular (23.3%) and digestive (20.3%). Co-occurring anomalies were associated with male, female, American Indian, Caucasian, prenatally diagnosed, chromosomal defects, and mortality (P < 0.00001). Gene clusters on 21q22.11 and 21q22.3 (KRTAP), 18q21.33 (SERPINB), 18q22.1 (CDH7, CDH19), 13q12.3 (FLT1), 13q22.1 (KLF5), 13q22.3 (EDNRB), and 13q34 (COL4A1, COL4A2, F7, F10) were significantly related to biological processes: blood pressure regulation and/or vessel integrity, angiogenesis, coagulation, cell-cell and/or cell-matrix adhesion, dermis integrity, and wound healing (P < 0.05). CONCLUSIONS Our findings suggest that gastroschisis may result from the interaction of several chromosomal regions in an additive manner as a pool of candidate genes were identified from critical regions supporting a role for vascular disruption, thrombosis, and mesodermal deficiency in the pathogenesis of gastroschisis.
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Affiliation(s)
- Victor M Salinas-Torres
- Departamento de Genética, Facultad de Medicina y Hospital Universitario José Eleuterio González, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos S/N Col. Mitras Centro, CP 64460, Monterrey, Nuevo León, México.
| | - Rafael A Salinas-Torres
- Departamento de Sistemas y Computación, Instituto Tecnológico de Tijuana, Calzada del Tecnológico S/N Fracc. Tomas Aquino, CP 22414, Tijuana, Baja California, México
| | - Ricardo M Cerda-Flores
- Universidad Autónoma de Nuevo León, Facultad de Enfermería, Dr. José Eleuterio González 1500, Mitras Centro, CP 64460, Monterrey, Nuevo León, México
| | - Hugo L Gallardo-Blanco
- Departamento de Genética, Facultad de Medicina y Hospital Universitario José Eleuterio González, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos S/N Col. Mitras Centro, CP 64460, Monterrey, Nuevo León, México
| | - Laura E Martínez-de-Villarreal
- Departamento de Genética, Facultad de Medicina y Hospital Universitario José Eleuterio González, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos S/N Col. Mitras Centro, CP 64460, Monterrey, Nuevo León, México
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7
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Marshall J, Salemi JL, Tanner JP, Ramakrishnan R, Feldkamp ML, Marengo LK, Meyer RE, Druschel CM, Rickard R, Kirby RS. Prevalence, Correlates, and Outcomes of Omphalocele in the United States, 1995–2005. Obstet Gynecol 2015; 126:284-293. [DOI: 10.1097/aog.0000000000000920] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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8
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Benjamin B, Wilson GN. Anomalies associated with gastroschisis and omphalocele: analysis of 2825 cases from the Texas Birth Defects Registry. J Pediatr Surg 2014; 49:514-9. [PMID: 24726103 DOI: 10.1016/j.jpedsurg.2013.11.052] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/08/2013] [Accepted: 11/09/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND/PURPOSE The increasing prevalence of abdominal wall defects prompted analysis of anomalies associated with gastroschisis and omphalocele in the Texas Birth Defects Registry (TDBR). METHODS Cases of gastroschisis (ICD9 code 756.71), omphalocele (756.70), and/or unspecified anomalies of the abdominal wall (756.79) were obtained from the TDBR after IRB approval and analyzed using Microsoft Access© and Excel© databases. RESULTS Analysis began with 2825 cases including 1831 of gastroschisis, 814 of omphalocele, and 180 of unspecified abdominal wall defects plus 9680 associated anomalies that were classified according to system. The overall prevalence of abdominal wall defects among 3,806,299 Texas births from 1999 to 2008 was 7.4 per 10,000 with 4.8 per 10,000 for gastroschisis and 2.1 for omphalocele. After excluding ambiguous cases (8.5% possibly misclassified), anomaly spectra were similar for the two AWD with musculoskeletal (limb contractures or defects), cardiovascular, gastrointestinal, urogenital, and central nervous system defects being most common. Of 1831 cases with gastroschisis, 594 (32%) had associated anomalies compared to 654 (80%) of 814 omphalocele cases. CONCLUSIONS Gastroschisis as well as omphalocele has significant associated anomalies that are important to appreciate during pre- and postnatal management.
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Affiliation(s)
- Bonna Benjamin
- Pediatric Surgery, Department of Pediatrics, Texas Tech University Health Science Center, Amarillo, TX 79106, USA.
| | - Golder N Wilson
- Pediatric Genetics, Departments of Pediatrics, Obstetrics & Gynecology, Texas Tech University Health Science Center, Amarillo and Lubbock (Pediatrics), Amarillo, TX 79106, USA
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9
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Rocha FG, Zalud I, Dye T. Ethnic variation of gastroschisis and omphalocele in the United States of America. J Matern Fetal Neonatal Med 2013; 27:1428-30. [PMID: 24328604 DOI: 10.3109/14767058.2013.876002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Gastroschisis and omphalocele are the most common fetal abdominal wall defects (AWDs). Ethnic factors have been implicated in the incidence data from some states in the United States. Our aim was to examine ethnic variation in the prevalence of gastroschisis and omphalocele in the US live birth population between 2006 and 2010. METHODS AWDs were identified through gastroschisis and omphalocele checkboxes from publicly available US Natality data (2006 to 2010). Ethnicity was evaluated by individual category using National Center for Health Statistics (NCHS) definitions. Adjusted multinomial logistic regression (SPSS v.19) was used to generate odds ratios (OR) in order to quantify the disparities. RESULTS In the US, 7867 live births were identified with AWD. All ethnic groups showed a significantly higher OR when compared with women of East/South Asian descent, which experienced the lowest prevalence. Women of indigenous ethnicity had the highest individual OR while their adjusted OR remained greater than 4.0. CONCLUSIONS Women of indigenous origin from North America and the Pacific had the highest rates of AWD. Within this group, women of Hawaiian descent had the highest point estimate of AWD when compared with other ethnic groups, though not significant.
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Affiliation(s)
- Frederico G Rocha
- Department of Obstetrics, Gynecology and Women's Health, John A. Burns School of Medicine, University of Hawaii , Honolulu, HI , USA
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South AP, Stutey KM, Meinzen-Derr J. Metaanalysis of the prevalence of intrauterine fetal death in gastroschisis. Am J Obstet Gynecol 2013; 209:114.e1-13. [PMID: 23628262 DOI: 10.1016/j.ajog.2013.04.032] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 04/02/2013] [Accepted: 04/24/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of this study was to review the medical literature that has reported the risk for intrauterine fetal death (IUFD) in pregnancies with gastroschisis. STUDY DESIGN We systematically searched the literature to identify all published studies of IUFD and gastroschisis through June 2011 that were archived in MEDLINE, PubMed, or referenced in published manuscripts. The MESH terms gastroschisis or abdominal wall defect were used. RESULTS Fifty-four articles were included in the metaanalysis. There were 3276 pregnancies in the study and a pooled prevalence of IUFD of 4.48 per 100. Those articles that included gestational age of IUFD had a pooled prevalence of IUFD of 1.28 per 100 births at ≥36 weeks' gestation. The prevalence did not appear to increase at >35 weeks' gestation. CONCLUSION The overall incidence of IUFD in gastroschisis is much lower than previously reported. The largest risk of IUFD occurs before routine and elective early delivery would be acceptable. Risk for IUFD should not be the primary indication for routine elective preterm delivery in pregnancies that are affected by gastroschisis.
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Affiliation(s)
- Andrew P South
- Division of Neonatology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Kielb C, Lin S, Herdt-Losavio M, Bell E, Chapman B, Rocheleau CM, Lawson C, Waters M, Stewart P, Olney RS, Romitti PA, Cao Y, Druschel C. Maternal periconceptional occupational exposure to pesticides and selected musculoskeletal birth defects. Int J Hyg Environ Health 2013; 217:248-54. [PMID: 23871272 DOI: 10.1016/j.ijheh.2013.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 05/28/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
Abstract
This population-based U.S. study investigated the association between major musculoskeletal malformations and periconceptional maternal occupational pesticide exposure for a wide range of occupations. We conducted a multi-site case-control analysis using data from the National Birth Defects Prevention Study among employed women with due dates from October 1, 1997 through December 31, 2002. Cases included 871 live-born, stillborn, or electively terminated fetuses with isolated craniosynostosis, gastroschisis, diaphragmatic hernia, or transverse limb deficiencies. Controls included 2857 live-born infants without major malformations. Using self-reported maternal occupational information, an industrial hygienist used a job-exposure matrix and expert opinion to evaluate the potential for exposure to insecticides, herbicides or fungicides for each job held during one month pre-conception through three months post-conception. Exposures analyzed included any exposure (yes/no) to pesticides, to insecticides only, to both insecticides and herbicides (I+H) and to insecticides, herbicides and fungicides (I+H+F). We used logistic regression to evaluate the association between exposures and defects, controlling for infant and maternal risk factors. Occupational exposure to I+H+F was associated with gastroschisis among infants of women aged 20 years or older (adjusted odds ratio [aOR]=1.88; 95% confidence interval [CI]: 1.16-3.05), but not for women under age 20 (aOR=0.48; 95% CI: 0.20-1.16). We found no significant associations for the other defects. Additional research is needed to validate these findings in a separate population.
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Affiliation(s)
- Christine Kielb
- NYS Department of Health, Center for Environmental Health, Troy, NY, United States.
| | - Shao Lin
- NYS Department of Health, Center for Environmental Health, Troy, NY, United States; University at Albany School of Public Health, Rensselaer, NY, United States
| | - Michele Herdt-Losavio
- NYS Department of Health, Center for Environmental Health, Troy, NY, United States; University at Albany School of Public Health, Rensselaer, NY, United States
| | - Erin Bell
- University at Albany School of Public Health, Rensselaer, NY, United States
| | - Bonnie Chapman
- Upstate Medical University, SUNY, Syracuse, NY, United States
| | - Carissa M Rocheleau
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (CDC), Cincinnati, OH, United States
| | - Christina Lawson
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (CDC), Cincinnati, OH, United States
| | - Martha Waters
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention (CDC), Cincinnati, OH, United States
| | | | - Richard S Olney
- National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA, United States
| | - Paul A Romitti
- University of Iowa School of Public Health, Iowa City, IA, United States
| | - Yanyan Cao
- University of Iowa School of Public Health, Iowa City, IA, United States
| | - Charlotte Druschel
- NYS Department of Health, Center for Environmental Health, Troy, NY, United States; University at Albany School of Public Health, Rensselaer, NY, United States
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Khodr ZG, Lupo PJ, Canfield MA, Chan W, Cai Y, Mitchell LE. Hispanic ethnicity and acculturation, maternal age and the risk of gastroschisis in the national birth defects prevention study. ACTA ACUST UNITED AC 2013; 97:538-45. [DOI: 10.1002/bdra.23140] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 03/20/2013] [Accepted: 03/22/2013] [Indexed: 11/05/2022]
Affiliation(s)
- Zeina G. Khodr
- Division of Epidemiology; Human Genetics and Environmental Sciences, University of Texas School of Public Health; Houston; Texas
| | | | - Mark A. Canfield
- Birth Defects Epidemiology and Surveillance Branch; Texas Department of State Health Services; Austin; Texas
| | - Wenyaw Chan
- Division of Biostatistics; University of Texas school of Public Health; Houston; Texas
| | - Yi Cai
- Division of Biostatistics; University of Texas school of Public Health; Houston; Texas
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Omphalocele, gastroschisis: epidemiology, survival, and mortality in Imam Khomeini hospital, Ahvaz-Iran. POLISH JOURNAL OF SURGERY 2012; 84:82-5. [PMID: 22487740 DOI: 10.2478/v10035-012-0013-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
UNLABELLED Gastroschisis and omphalocele are the most common malformation of the anterior abdominal wall.The aim of the study was to determine the abdominal wall defect frequencies, survival, and mortalities in Ahvaz, Khuzestan province of Iran.Materiał and methods. All cases born with omphalocele or gastroschisis whom born in Imam Khomeini hospital, were included in this study. Duration of study was 3 years from April 2005. All patients treated at Imam Khomeini hospital in Ahwaz, Iran.Results. Among 15321 consecutive births, 42 patients had abdominal wall deformity. Overall incidence was 27.41 per 10,000 live births. Of all cases, 18 (42.9%) of cases were male and 24 (57.1%) were female. Of all cases, 21.7% of patients with omphalocele and 10% patients with gastroschisis had other anomalies. Of all cases, 71.8% of patients with omphalocele and 60% with gastroschisis underwent surgery. The type of anomaly (omphalocele and gastroschisis) had correlation with post operation prognosis significantly (p<0.001). Of 66.7% of patients under went surgery, 46.4% with mesh and 53.6% without mesh performed. 80% of patients with omphalocele and 20% with gastroschisis were lived. CONCLUSIONS In our study, mortality was significantly higher in cases with gastroschisis than cases with omphalocele.
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Khalil A, Arnaoutoglou C, Pacilli M, Szabo A, David AL, Pandya P. Outcome of fetal exomphalos diagnosed at 11-14 weeks of gestation. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2012; 39:401-406. [PMID: 21793081 DOI: 10.1002/uog.10048] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To determine whether sonographic findings in cases of exomphalos detected at the 11-14-week scan can be used to guide pregnancy management. METHODS Retrospective study of cases of exomphalos identified from the Fetal Medicine Unit database, University College London Hospitals between January 1998 and January 2010. Pregnancy and neonatal data were ascertained from maternal and neonatal records. Fetal exomphalos was categorized into three groups: exomphalos associated with other major structural malformation(s), isolated exomphalos with increased nuchal translucency (NT) and isolated exomphalos with normal NT. RESULTS A total of 98 cases of exomphalos were identified, of which 45 (45.9%) were associated with other major structural malformation(s), identified antenatally. Isolated exomphalos was found with increased NT in 22 cases (22.4%) and with normal NT in 31 cases (31.6%). Of 80 (81.6%) fetuses that were karyotyped, 43 (53.8%) had a chromosomal abnormality; the most common aneuploidy was trisomy 18 (n = 31; 72.1%). Where exomphalos was associated with other major structural abnormalities, or was isolated with increased NT, the incidence of aneuploidy was high, at 78.9% and 72.2%, respectively. Cases of isolated exomphalos with normal NT were all euploid. In 21 cases (21.4%), exomphalos resolved later in pregnancy and none had apparent abnormalities at birth; isolated exomphalos persisted in only three neonates (3.1%). CONCLUSIONS The finding of a major structural abnormality or of increased NT in association with exomphalos in the first trimester implies a high risk of aneuploidy. Parents can be reassured that fetuses with isolated exomphalos and normal NT are likely to be euploid.
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Affiliation(s)
- A Khalil
- Fetal Medicine Unit, Institute for Women's Health, University College London Hospitals NHS Foundation Trust, London, UK.
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Frolov P, Alali J, Klein MD. Clinical risk factors for gastroschisis and omphalocele in humans: a review of the literature. Pediatr Surg Int 2010; 26:1135-48. [PMID: 20809116 DOI: 10.1007/s00383-010-2701-7] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2010] [Indexed: 10/19/2022]
Abstract
Gastroschisis and omphalocele are usually considered together since they are both congenital abdominal wall defects, and yet their anatomy, embryogenesis, and clinical presentation and problems are quite different. In addition, it appears that the risk factors for their occurrence differ. Etiologic factors contributing to the development of these defects are unknown. To investigate this we have reviewed reports of risk factors for each anomaly and report them here. We conducted a literature search using PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) for risk factors implicated in the development of gastroschisis and omphalocele. The data reviewed here from clinical studies in the literature, closely parallels the data in animal studies which we reported earlier. There is little evidence for a genetic cause in the development of gastroschisis and much evidence supporting the possibility that environmental teratogens are important contributors to the development of this defect. On the other hand, in the case of omphalocele, there was little evidence for environmental factors and substantial data indicating that genetic or familial factors may play an important role.
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Affiliation(s)
- Polina Frolov
- Department of Surgery, Children's Hospital of Michigan, Wayne State University, 3901 Beaubien Street, Detroit, MI 48201-2119, USA
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Mac Bird T, Robbins JM, Druschel C, Cleves MA, Yang S, Hobbs CA. Demographic and environmental risk factors for gastroschisis and omphalocele in the National Birth Defects Prevention Study. J Pediatr Surg 2009; 44:1546-51. [PMID: 19635303 DOI: 10.1016/j.jpedsurg.2008.10.109] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 10/24/2008] [Accepted: 10/24/2008] [Indexed: 10/20/2022]
Abstract
BACKGROUND Primary prevention efforts for both gastroschisis and omphalocele are limited by the lack of known risk factors. Our objective was to investigate associations between potential maternal risk factors and gastroschisis and omphalocele within a large population-based sample of participants enrolled in the National Birth Defects Prevention Study (NBDPS). METHODS Demographic, health-related, and environmental exposure data from the NBDPS were collected from women with expected delivery dates between October 1997 and December 2003. Data were collected on 485 cases of gastroschisis, 168 cases of omphalocele, and 4967 controls. RESULTS Women who had offspring with gastroschisis were younger (adjusted odds ratio [AOR], 0.84; 95% confidence interval [CI], 0.81-0.86) and less likely to be black (AOR, 0.54; 95% CI, 0.34-0.85) than controls. They also were more likely to have smoked (AOR, 1.51; 95% CI, 1.12-2.03), taken ibuprofen (AOR, 1.61; 95% CI, 1.23-2.10), and consumed alcohol (AOR, 1.38; 95% CI, 1.06-1.79) than controls. Women who had offspring with omphaloceles were more likely to have consumed alcohol (AOR, 1.53; 95% CI, 1.04-2.25) and be heavy smokers (AOR, 4.26; 95% CI, 1.58-11.52) than controls. CONCLUSIONS Our results suggest a moderately increased risk of gastroschisis among women who used tobacco, alcohol, and ibuprofen during early pregnancy. A modestly elevated risk was observed for omphaloceles among women who used alcohol during the first trimester and among women who were heavy smokers.
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Affiliation(s)
- T Mac Bird
- Department of Pediatrics, Center for Applied Research and Evaluation, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72202-3591, USA
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Hidaka N, Murata M, Yumoto Y, Hojo S, Fujita Y, Masumoto K, Taguchi T, Tsukimori K, Wake N. Characteristics and perinatal course of prenatally diagnosed fetal abdominal wall defects managed in a tertiary center in Japan. J Obstet Gynaecol Res 2009; 35:40-7. [PMID: 19215546 DOI: 10.1111/j.1447-0756.2008.00871.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To identify the clinical characteristics of fetal abdominal wall defects managed at a single institution and to provide information regarding the most likely clinical course of the affected fetuses. METHODS A retrospective review was conducted of 44 fetuses prenatally diagnosed with abdominal wall defects at Kyushu University Hospital between 1990 and 2006. RESULTS A total of 11 cases of gastroschisis and 33 cases of omphalocele were found. Preterm delivery was observed in eight of 11 fetuses (72.7%) with gastroschisis and in 14 of 27 fetuses (51.9%) with omphalocele who were not artificially aborted. Intrauterine growth restriction (IUGR) was identified in four of 11 fetuses (36.4%) with gastroschisis and in 13 of 27 fetuses (48.1%) with omphalocele who were not aborted artificially. There was a high rate of associated structural anomalies with omphalocele (26/33). Karyotypic abnormalities were observed in eight of 29 tested fetuses with omphalocele (27.6%). The prognosis for a chromosomally normal fetus with omphalocele appeared to largely depend on the associated structural abnormalities and the gestational age at delivery. Despite the frequent presence of IUGR, the outcome of neonates with gastroschisis was good. CONCLUSIONS The possibility of preterm delivery and IUGR should be considered during the management of both omphalocele and gastroschisis. For the management of omphaloceles, chromosomal abnormalities and respiratory insufficiency after birth must also be considered. Timely prenatal diagnosis and the subsequent identification of associated anomalies will improve patient care and will enable clinicians to provide appropriate counseling about the expected course.
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Affiliation(s)
- Nobuhiro Hidaka
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Hidaka N, Tsukimori K, Hojo S, Fujita Y, Yumoto Y, Masumoto K, Taguchi T, Wake N. Correlation between the presence of liver herniation and perinatal outcome in prenatally diagnosed fetal omphalocele. J Perinat Med 2009; 37:66-71. [PMID: 18976045 DOI: 10.1515/jpm.2009.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS To investigate the association between the presence of liver herniation and perinatal course and outcome of fetal omphalocele. METHODS Cases of fetal omphalocele managed at our hospital between 1990 and 2006 were retrospectively reviewed and grouped according to the location of the liver. RESULTS Thirty-three fetal omphalocele cases were diagnosed. The chromosomal status of 29 of 33 fetuses was determined. The rate of chromosomal abnormalities in cases with an extracorporeal liver was significantly lower (2/18) than in the intracorporeal group (6/11) (P=0.028). In chromosomally normal cases, four with extracorporeal liver resulted in early neonatal death compared to none with intracorporeal liver. Five of the 21 chromosomally normal fetuses showed an abnormal volume of amniotic fluid. All five cases had extracorporeal liver and two of them resulted in neonatal death. CONCLUSIONS Fetuses with an extracorporeal liver had a lower rate of chromosomal abnormalities than those in the intracorporeal liver group. However, in chromosomally normal cases, it appeared that extracorporeal livers might be associated with more life-threatening anomalies, amniotic fluid volume abnormalities, and a higher rate of mortality than in the group with an intracorporeal liver. Upon diagnosis of fetal omphalocele, a careful search for liver location should be conducted before counseling.
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Affiliation(s)
- Nobuhiro Hidaka
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Srivastava V, Mandhan P, Pringle K, Morreau P, Beasley S, Samarakkody U. Rising incidence of gastroschisis and exomphalos in New Zealand. J Pediatr Surg 2009; 44:551-5. [PMID: 19302857 DOI: 10.1016/j.jpedsurg.2008.09.025] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Accepted: 09/26/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND An apparent increase in the incidence of gastroschisis and exomphalos has been reported from several parts of the world. The exact mechanism of this trend is unknown. The aim of this study was to determine the regional and national trends in the incidence of gastroschisis and exomphalos in New Zealand. MATERIAL AND METHODS This retrospective multicenter study involved collection of data from all 4 tertiary care pediatric surgical centers in New Zealand. The incidence was calculated per 10,000 live births. Data were analyzed to determine the regional and national trends. The statistical analysis was done using linear regression model and Poisson distribution. RESULTS The incidence of gastroschisis has increased from 2.96 per 10,000 live births to 5.16 per 10,000 live births between 1996 and 2004. During the same period, the incidence of exomphalos has increased from 0.69 per 10,000 live births to 3.27 per 10,000 live births. Gastroschisis was observed more in younger mothers, whereas exomphalos was associated with older mothers. CONCLUSION The incidence of gastroschisis and exomphalos is increasing in New Zealand, which is consistent with worldwide trends in showing the increasing incidence of anterior abdominal wall defects.
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Affiliation(s)
- Vijay Srivastava
- Department of Pediatric Surgery, Waikato Hospital, Hamilton 2240, New Zealand
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Chabra S. Is the prevalence of gastroschisis increasing in selected US states? J Pediatr Surg 2009; 44:476-7. [PMID: 19231563 DOI: 10.1016/j.jpedsurg.2008.10.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Accepted: 10/22/2008] [Indexed: 12/01/2022]
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Materna-Kiryluk A, Wiśniewska K, Badura-Stronka M, Mejnartowicz J, Wieckowska B, Balcar-Boroń A, Czerwionka-Szaflarska M, Gajewska E, Godula-Stuglik U, Krawczyński M, Limon J, Rusin J, Sawulicka-Oleszczuk H, Szwalkiewicz-Warowicka E, Walczak M, Latos-Bieleńska A. Parental age as a risk factor for isolated congenital malformations in a Polish population. Paediatr Perinat Epidemiol 2009; 23:29-40. [PMID: 19228312 DOI: 10.1111/j.1365-3016.2008.00979.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Currently available data on the relationship between the prevalence of isolated congenital malformations and parental age are inconsistent and frequently divergent. We utilised the data from the Polish Registry of Congenital Malformations (PRCM) to accurately assess the interplay between maternal and paternal age in the risk of isolated non-syndromic congenital malformations. Out of 902 452 livebirths we studied 8683 children aged 0-2 years registered in the PRCM. Logistic regression was used to simultaneously adjust the risk estimates for maternal and paternal age. Our data indicated that paternal and maternal age were independently associated with several congenital malformations. Based on our data, young maternal and paternal ages were independently associated with gastroschisis. In addition, young maternal age, but not young paternal age, carried a higher risk of neural tube defects. Advanced maternal and paternal ages were both independently associated with congenital heart defects. Moreover, there was a positive association between advanced paternal age and hypospadias, cleft palate, and cleft lip (with or without cleft palate). No significant relationships between parental age and the following congenital malformations were detected: microcephaly, hydrocephaly, oesophageal atresia, atresia or stenosis of small and/or large intestine, ano-rectal atresia or stenosis, renal agenesis or hypoplasia, cystic kidney disease, congenital hydronephrosis, diaphragmatic hernia and omphalocele.
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Affiliation(s)
- Anna Materna-Kiryluk
- Department of Medical Genetics, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
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Fillingham A, Rankin J. Prevalence, prenatal diagnosis and survival of gastroschisis. Prenat Diagn 2008; 28:1232-7. [DOI: 10.1002/pd.2153] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Changes in frequencies of select congenital anomalies since the onset of folic acid fortification in a Canadian birth defect registry. Canadian Journal of Public Health 2008. [PMID: 18767269 DOI: 10.1007/bf03403753] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Fortification of grain products with folic acid has been shown to significantly reduce the occurrence of neural tube defects (NTDs) in Canada and elsewhere. However, the impact on non-NTD anomalies has not been well studied. METHODS Using the Alberta Congenital Anomalies Surveillance System (ACASS), we examined changes in occurrence of select congenital anomalies where folic acid supplementation with multivitamins had previously been suggested to have an effect. Anomalies documented in the ACASS 1992-1996 (pre-fortification) were compared to 1999-2003 (post-fortification). RESULTS A significant decrease in spina bifida (OR 0.51, 95% CI 0.36-0.73) and ostium secundum atrial septal defects (OR 0.80, 95% CI 0.69-0.93) was evident, but there was a significant increase in obstructive defects of the renal pelvisand ureter (OR 1.45, 95% CI 1.24-1.70), abdominal wall defects (OR 1.40, 95% CI 1.04-1.88) and pyloric stenosis (OR 1.49, 95% CI 1.18-1.89). CONCLUSIONS Consistent with other studies, a 50% reduction in spina bifida was associated with the post-fortification time period. Supporting the possibility that folic acid fortification may play a role in preventing other birth defects, a 20% reduction in atrial septal defects was also associated. The increase in abdominal wall defects, most notably gastroschisis, is likely related to pre-existing increasing trends documented in several regions around the world. The increase in pyloric stenosis and obstructive urinary tract defects was not expected and any causal relationship with folic acid fortification remains unclear. Similar studies by other birth defects surveillance systems in Canada and elsewhere are needed to confirm these trends.
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Rasmussen SA, Frías JL. Non-genetic risk factors for gastroschisis. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2008; 148C:199-212. [DOI: 10.1002/ajmg.c.30175] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hunter AG, Stevenson RE. Gastroschisis: Clinical presentation and associations. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2008; 148C:219-30. [DOI: 10.1002/ajmg.c.30178] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Collins SR, Griffin MR, Arbogast PG, Walsh WF, Rush MR, Carter BS, Dudley J, Cooper WO. The rising prevalence of gastroschisis and omphalocele in Tennessee. J Pediatr Surg 2007; 42:1221-4. [PMID: 17618884 DOI: 10.1016/j.jpedsurg.2007.02.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Rates of the major congenital abdominal wall defects gastroschisis and omphalocele have been shown to be increasing over the past 10 to 20 years. Although much of the increase was seen in the 1970s and 1980s, there has been conflicting evidence as to whether similar trends exist for more recent years. Clinical observations from the major neonatal referral networks in Tennessee led us to question whether the rates of abdominal wall defects were continuing to increase throughout the 1990s. The purpose of this study was to describe the rates of congenital abdominal wall defects between 1985 and 2002 for the state of Tennessee using 2 independently collected data sources: birth certificates and Medicaid claims. There was nearly a 3-fold increase in congenital abdominal wall defects between 1989 and 2001 identified from birth certificates, and a doubling of these defects was identified from claims. Temporal increases persisted when controlling for maternal age, race, and education. We conclude that the increase in these important birth defects seen in earlier decades has persisted in Tennessee in recent years. Further elucidation of risk factors associated with the increase is warranted.
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Affiliation(s)
- Sonya R Collins
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 37232-2504, USA
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27
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Abstract
PURPOSE Local and state registries have shown recent increases in the prevalence of gastroschisis in the United States and abroad. The purpose of this study was to use a nationally representative database to identify national trends in the prevalence of gastroschisis repairs. METHODS Records of infants undergoing gastroschisis repair were identified in the Nationwide Inpatient Sample from 1996 to 2003. Birth data were obtained from the National Center for Health Statistics and used to calculate the rate of procedures/live births stratified by US census region. Survey statistics were used to account for the sampling design of the Nationwide Inpatient Sample database. RESULTS Between 1996 and 2003, a total of 9459 gastroschisis repairs were performed in the United States (3 procedures for every 10,000 births). A significant increase in the population-based rate of these procedures was observed in each census regions and nationwide. A twofold higher procedure rate was observed in 2003 than in 1996 (rate ratio, 2.0; 95% confidence interval, 1.1-2.9; P < .001). No significant change in unadjusted hospital mortality was observed regionally or nationally. CONCLUSIONS The population-based rate of gastroschisis repairs significantly increased regionally and nationwide between 1996 and 2003, paralleling recent trends described at the local and state level.
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Affiliation(s)
- Sonia M Alvarez
- Division of Pediatric Surgery, Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA
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Abstract
Fetuses with omphalocele have an increased risk for chromosomal abnormalities. The risk varies with maternal age, gestational age at diagnosis, association with umbilical cord cysts, complexity of associated anomalies, and the contents of omphalocele. There is considerable evidence that genetics contributes to the etiology of omphalocele. This article provides an overview of chromosomal abnormalities associated with omphalocele and a comprehensive review of associated full aneuploidy such as trisomy 18, trisomy 13, triploidy, trisomy 21, 45,X, 47,XXY, and 47,XXX, partial aneuploidy such as dup (3q), dup (11p), inv (11), dup (1q), del (1q), dup (4q), dup (5p), dup (6q), del (9p), dup (15q), dup(17q), Pallister-Killian syndrome with mosaic tetrasomy 12p and Miller-Dieker lissencephaly syndrome with deletion of 17p13.3, and uniparental disomy (UPD) such as UPD 11 and UPD 14. Omphalocele is a prominent marker for chromosomal abnormalities. Perinatal identification of omphalocele should alert chromosomal abnormalities and familial unbalanced translocations, and prompt thorough cytogenetic investigations and genetic counseling.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
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Mastroiacovo P, Lisi A, Castilla EE, Martínez-Frías ML, Bermejo E, Marengo L, Kucik J, Siffel C, Halliday J, Gatt M, Annerèn G, Bianchi F, Canessa MA, Danderfer R, de Walle H, Harris J, Li Z, Lowry RB, McDonell R, Merlob P, Metneki J, Mutchinick O, Robert-Gnansia E, Scarano G, Sipek A, Pötzsch S, Szabova E, Yevtushok L. Gastroschisis and associated defects: An international study. Am J Med Genet A 2007; 143A:660-71. [PMID: 17357116 DOI: 10.1002/ajmg.a.31607] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Our objective was to evaluate the frequency and type of malformations associated with gastroschisis in a large pool of international data, to identify malformation patterns, and to evaluate the role of maternal age in non-isolated cases. Case-by-case information from 24 registries, all members of the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR), were evaluated. After the exclusion of other abdominal wall defects cases were classified as: (a) isolated; (b) recognizable syndrome, chromosomal or not; (c) multiple congenital anomalies (MCA). Our results showed that out of 3,322 total cases 469 non-isolated cases were registered (14.1%): 41 chromosomal syndromes, 24 other syndromes, and 404 MCA. Among MCA four groups of anomalies were most frequent: CNS (4.5%), cardio-vascular (2.5%), limb (2.2%), and kidney anomalies (1.9%). No similar patterns emerged except two patterns resembling limb-body wall complex and OEIS. In both of them the gastroschisis could be however misclassified. Chromosomal trisomies and possibly non-syndromic MCA are associated with an older maternal age more than isolated cases. On consideration of our data and the most valid studies published in the literature, the best estimate of the proportion of gastroschisis associated with major unrelated defects is about 10%, with a few cases associated to recognizable syndromes. Recognized syndromes with gastroschisis seem to be so exceptional that the well documented and validated cases are worth being published as interesting case report. An appropriate case definition in etiological studies should include only isolated gastroschisis after an appropriate definition of isolated and non-isolated cases and a thorough case-by-case review.
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Affiliation(s)
- Pierpaolo Mastroiacovo
- Centre of the International Clearinghouse for Birth Defects Surveillance and Research, Rome, Italy.
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