DEMOGRAPHIC, REPRODUCTIVE, MEDICAL, AND ENVIRONMENTAL-FACTORS IN RELATION TO GASTROSCHISIS

To identify risk factors for gastroschisis other than drug use in preg nancy, an analysis of data collected in a case-control surveillance pr ogram of birth defects (1976-1990) was conducted. Drug use is consider ed in Werler et al., Teratology, 45:361-367, 1992. Maternal demographi c, reproductive, and medical factors, and first trimester environmenta l exposures, were compared between 76 gastroschisis cases and 2,581 ma lformed controls. A strong inverse association was found for maternal age: relative to women 30 years or older, relative risks for 25-29, 20 -24, and < 20-year-old women were 1.7, 5.4, and 16, respectively. Mult ivariate relative risks (and 95% confidence intervals) for alcohol use were as follows: for 1-5 drinks per week, 1.6 (0.7-3.4); for greater- than-or-equal-to 6 drinks per week, 2.5 (0.9-6.8); for a maximum of 1- 4 drinks at any one time, 0.8 (0.4-1.6); and for a maximum of greater- than-or-equal-to 5 drinks, 2.8 (1.2-6.5). With the effect of age taken into account, no associations were identified for cigarette smoking, consumption of caffeinated or decaffeinated coffee, unplanned pregnanc y, 12 or less years of education, or a parity of two or more. Other me dical and reproductive factors, including weight gain, vaginal bleedin g, nausea or vomiting, influenza, "other" infection, and history of sp ontaneous abortion or elective abortion did not increase the risk.