Epidemiology of abdominal wall defects, Hawaii, 1986-1997

The various types of abdominal wall defects are considered to differ in the ir etiologies, a hypothesis suggested by differences in their epidemiologie s. This study examined the impact of selected demographic factors on abdomi nal wall defects (omphalocele, gastroschisis, and body stalk anomaly) inclu ded in a birth defects registry in Hawaii from 1986-1997. The total prevale nce for the various defects were: omphalocele (2.76 per 10,000 births, 95% confidence interval (CI), 2.14-3.50), gastroschisis (3.01, 95% CI, 2.36-3.7 7), and body stalk anomalies (0.32, 95% CI, 0.14-0.64). The prevalence incr eased over the 12-year period for both omphalocele (P = 0.052) and gastrosc hisis (P = 0.008). Women less than age 20 were at increased risk for a gast roschisis-affected pregnancy, while those age 40 and over were disproportio nately more likely to have an omphalocele-affected pregnancy. Pacific Islan ders had the lowest risk for omphalocele, whereas Far East Asians were leas t likely to have gastroschisis. Omphalocele rates were lower outside metrop olitan Honolulu, while place of residence did not significantly impact gast roschisis risk. The 1-year survival rate was higher for gastroschisis than for omphalocele (88.5% and 70.7%, respectively), while none of the infants with body stalk anomalies was live-born. The results of this study tend to support the hypothesis of differing etiologies for the studied abdominal wa ll defects. Teratology 60:117-123, 1999. (C) 1999 Wiley-Liss, Inc.