INCREASE IN INCIDENCE OF GASTROSCHISIS IN THE SOUTH-WEST OF ENGLAND IN 1995

Objective To describe the incidence of gastroschisis and to identify p ossible aetiological factors. Design A retrospective case review study . Setting The South West Region of England. Population All known cases of gastroschisis were identified from the regional fetal medicine, ul trasound, pathology and neonatal surgery databases. Datasets to be col lected were agreed prospectively and included demographic, past medica l, family and obstetric information for all pregnancies conceived betw een January 1987 and December 1995. Results In the first eight years t he incidence was 1.6/10,000 but in 1995 a highly statistically signifi cant rise to 4.4/10,000 was found (P = 0.0009). The increased incidenc e was not associated with changes in maternal age, proportion of primi gravidae, use of tobacco or illicit drugs, conception while taking the oral contraceptive pill, or an increase in the number of teenage preg nancies. The median maternal age at last menstrual period for pregnanc ies with gastroschisis was 20.4 years which was much younger than the national average of 28 years. Thirty-seven percent of these conception s occurred during the first quarter of the year compared with the expe cted 25%. Conclusions The incidence of gastroschisis has risen to a hi gher level than previously reported which, despite a marked associatio n with young maternal age at conception, is not due to an increase in the teenage pregnancy rate. As the average length of inpatient stay in the neonatal intensive care unit for cases with this malformation is approximately four weeks, the rise has considerable cost implications. The increasing incidence may also offer opportunities to determine th e cause of gastroschisis.