Case-control study of a gastroschisis cluster in Nevada

Arch Pediatr Adolesc Med. 2009 Nov;163(11):1000-6. doi: 10.1001/archpediatrics.2009.186.

Abstract

Objective: To identify potential risk factors associated with a sudden increase in gastroschisis cases in northern Nevada.

Design: Case-control study.

Setting: Medical centers and a pregnancy care center in Reno, Nevada.

Participants: Participants (n = 14) were women who gave birth to infants with gastroschisis at either of the 2 medical centers in Reno, Nevada, from April 5, 2007, through April 4, 2008. Controls (n = 57) were selected from the same pregnancy center providing perinatal care to the cases and were matched 4:1 to the case mothers by maternal date of birth within 1 year.

Main exposures: Environmental exposures and illnesses during pregnancy.

Outcome measures: Association of gastroschisis with illnesses, medications, or environmental exposures.

Results: Gastroschisis was associated with the use of methamphetamine (odds ratio [OR], 7.15; 95% confidence interval [CI], 1.35-37.99) or any vasoconstrictive recreational drug (methamphetamine, amphetamine, cocaine, ecstasy) (OR, 4.46; 95% CI, 1.21-16.44) before pregnancy. When we limited self-reported illnesses to those occurring during the first trimester of pregnancy, chest colds (OR, 16.77; 95% CI, 1.88-150.27) and sore throats (OR, 12.72; 95% CI, 1.32-122.52) were associated with gastroschisis.

Conclusions: These findings add strength to the hypothesis that use of methamphetamine and related drugs is a risk factor for gastroschisis and raise questions about the risks associated with infections.

MeSH terms

  • Case-Control Studies
  • Common Cold / drug therapy
  • Common Cold / epidemiology
  • Female
  • Gastroschisis / epidemiology*
  • Gastroschisis / etiology
  • Humans
  • Infant, Newborn
  • Nasal Decongestants / therapeutic use
  • Nevada / epidemiology
  • Pharyngitis / epidemiology
  • Pregnancy
  • Pseudoephedrine / therapeutic use
  • Risk Factors
  • Substance-Related Disorders / epidemiology
  • Surveys and Questionnaires

Substances

  • Nasal Decongestants
  • Pseudoephedrine