Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 101
Filtrar
1.
Int J Gynaecol Obstet ; 149(3): 347-353, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32115707

RESUMO

OBJECTIVE: To evaluate risk factors associated with fetal gastroschisis. METHODS: As a secondary aim of a larger case-control study, pregnant women attending the Fetal Medicine Unit at the Department of Obstetrics and Gynecology at Hospital das Clinicas, Sao Paulo University Medical School between July 1, 2013, and July 31, 2015, were allocated into either the gastroschisis group, where the woman was carrying a fetus with gastroschisis, or the control group, where the fetus was normal. Patients in the control group were matched at study entry for maternal age, preconception body mass index and weeks of gestation. In-person interviews were conducted during pregnancy to obtain data on demographic, medical, and social characteristics; exposure to substances; pregnancy history; the presence of chronic disease, urinary tract infections (UTIs), influenza, and fever; and the occurrence of stress events between the month before the last menstrual period and the first trimester of pregnancy. RESULTS: Of 171 women included in the study, 57 were allocated to the gastroschisis group and 114 to the control group. There were significant associations between gastroschisis and maternal UTI (P=0.011), tobacco use (P=0.001), alcohol consumption (P≤0.001), and illicit drug use (P=0.012). After analysis by standard logistic regression, the remaining significant factors were UTI, tobacco use, and alcohol consumption. CONCLUSION: UTI and exposure to tobacco or alcohol just before conception and during early pregnancy were associated with an increase in the likelihood of fetal gastroschisis.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Gastrosquise/epidemiologia , Fumar/epidemiologia , Infecções Urinárias/epidemiologia , Adulto , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Doenças Fetais/etiologia , Gastrosquise/etiologia , Humanos , Modelos Logísticos , Gravidez , Primeiro Trimestre da Gravidez , Fatores de Risco , Adulto Jovem
2.
Arch Dis Child ; 105(8): 756-764, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32051127

RESUMO

BACKGROUND: Gastroschisis is strongly associated with young maternal age. This association suggests the need for further investigations on non-genetic risk factors. Identifying these risk factors is a public health priority in order to develop prevention strategies aimed at reducing the prevalence and health consequences in offspring. OBJECTIVE: To systematically assess and quantitatively synthesise the available epidemiological studies to evaluate the association between non-genetic risk factors and gastroschisis. METHODS: Literature from PubMed, EMBASE and Scopus was searched for the period 1990-2018. Epidemiological studies reporting risk estimates between lifestyle and sociodemographic risk factors and gastroschisis were included. Two pairs of reviewers independently extracted information on study characteristics following Preferred Reporting Items for Systematic Reviews and Meta-Analyses and MOOSE (Meta-analysis Of Oservational Studies in Epidemiology) guidelines. Relative risk (RR) estimates were calculated across the studies and meta-analysis was performed using random-effects model. RESULTS: We identified 58 studies. Meta-analyses were conducted on 29 studies. Maternal smoking (RR 1.56, 95% CI 1.40 to 1.74), illicit drug use (RR 2.14, 95% CI 1.48 to 3.07) and alcohol consumption (RR 1.40, 95% CI 1.13 to 1.70) were associated with an increased risk of gastroschisis. A decreased risk among black mothers compared with non-Hispanic white mothers (RR 0.49, 95% CI 0.38 to 0.63) was found. For Hispanic mothers no association was observed. CONCLUSIONS: Exposure to smoking, illicit drugs and alcohol during pregnancy is associated with an increased risk of gastroschisis. A significantly decreased risk for black mothers was observed. Further epidemiological studies to assess the potential role of other environmental factors are strongly recommended. PROSPERO REGISTRATION NUMBER: CRD42018104284.


Assuntos
Gastrosquise/etiologia , Estilo de Vida , Fatores Socioeconômicos , Feminino , Humanos , Idade Materna , Modelos Estatísticos , Fatores de Risco
3.
Eur J Pediatr Surg ; 29(4): 342-351, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31426117

RESUMO

The survival rate of newborns with gastroschisis (GS) has been increasing in the past decades; however, the morbidity continues to be high, mainly related to the length of hospitalization due to disturbances of motility, absorption, and risk of intestinal infections. The development of basic research with the creation of experimental models has provided enormous advances in the understanding of the pathophysiology of the disease. These models allowed the study of the target genes involved in the embryology of the defect, the influence of the amniotic fluid, and the use of drugs and fetal therapies in an attempt to reduce the intestinal damage and to provide a rapid return of intestinal motility. Our aim was to describe the main GS models and the translational, historical impact of these research advances on the disease.


Assuntos
Modelos Animais de Doenças , Gastrosquise , Pesquisa Médica Translacional/métodos , Animais , Gastrosquise/etiologia , Gastrosquise/fisiopatologia , Gastrosquise/terapia , Humanos
4.
Am J Med Genet A ; 179(8): 1535-1542, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31215128

RESUMO

Fetal gastroschisis is a paraumbilical abdominal wall defect with herniation of the abdominal organs. This multifactorial malformation occurs in young pregnant women, and the underlying cause of the disease remains unknown; however, nutritional factors may play a role in its development. This case-control study explored the association of maternal nutrient intake with the occurrence of gastroschisis. The gastroschisis group (GG) comprised 57 pregnant women with fetuses with gastroschisis, and the control group (CG) comprised 114 pregnant women with normal fetuses matched for maternal age, gestational age, and preconception body mass index classification. Nutritional assessments related to the preconception period were obtained using the food consumption frequency questionnaire, and nutrient intakes were calculated using nutrition programs. The median daily calorie intake was higher (2,382.43 vs. 2,198.81; p = .041) in the GG than in the CG. The median intake of methionine (763.89 vs. 906.34; p = .036) and threonine (1,248.34 vs. 1,437.01; p = .018) was lower in the GG than in the CG. Pregnant women with fetuses with gastroschisis have a diet characterized by higher calorie intake and lower levels of essential amino acids (methionine and threonine) during the preconception period than pregnant women with normal fetuses.


Assuntos
Ingestão de Energia , Doenças Fetais/epidemiologia , Doenças Fetais/etiologia , Gastrosquise/epidemiologia , Gastrosquise/etiologia , Exposição Materna , Nutrientes , Adulto , Estudos de Casos e Controles , Feminino , Feto , Gastrosquise/diagnóstico , Idade Gestacional , Humanos , Micronutrientes , Nutrientes/administração & dosagem , Razão de Chances , Gravidez , Adulto Jovem
5.
BMJ Open ; 9(3): e026297, 2019 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-30928950

RESUMO

OBJECTIVE: To assess the association between occurrence and timing of maternal self-reported genitourinary tract infection (urinary tract infections [UTIs] and/or sexually transmitted infection [STI]) and risk for gastroschisis in the offspring. DESIGN: Population-based case-control study. SETTING: National Birth Defects Prevention Study, a multisite study in the USA. PARTICIPANTS: Mothers of 1366 gastroschisis cases and 11 238 healthy controls. MAIN OUTCOME MEASURES: Crude and adjusted ORs (aORs) with 95% CIs. RESULTS: Genitourinary infections were frequent in case (19.3%) and control women (9.9%) during the periconceptional period (defined as 3 months prior to 3 months after conception). UTI and/or STI in the periconceptional period were associated with similarly increased risks for gastroschisis (aOR 1.5, 95% CI 1.3 to 1.8; aOR 1.6, 95% CI 1.2 to 2.3, respectively). The risk was increased with a UTI before (aOR 2.5; 95% CI 1.4 to 4.5) or after (aOR 1.7; 95% CI 1.1 to 2.6) conception only among women ≥25 years of age. The risk was highest among women <20 years of age with an STI before conception (aOR 3.6; 95% CI 1.5 to 8.4) and in women ≥25 years of age, the risk was similar for before (aOR 2.9; 95% CI 1.0 to 8.5) and after (aOR 2.8; 95% CI 1.3 to 6.1) conception. A specific STI pathogen was reported in 89.3% (50/56) of cases and 84.3% (162/191) of controls with Chlamydia trachomatis the most common (25/50 cases, 50%; 58/162 controls, 36%) and highest among women <20 years of age (16/25 cases, 64%; 22/33 controls, 67%). CONCLUSIONS: UTI and/or STI were associated with an increased risk for gastroschisis, with the strength of the association varying by maternal age and timing of infection.


Assuntos
Gastrosquise/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Doenças Sexualmente Transmissíveis/complicações , Infecções Urinárias/complicações , Adulto , Estudos de Casos e Controles , Infecções por Chlamydia/complicações , Feminino , Gastrosquise/etiologia , Humanos , Recém-Nascido , Masculino , Gravidez , Complicações Infecciosas na Gravidez/etiologia , Fatores de Risco , Adulto Jovem
6.
Birth Defects Res ; 111(6): 294-311, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30816021

RESUMO

Recent advances have now made it possible to speak of gastroschisis narrowly in morphogenetic terms invoking the Rittler-Beaudoin (R-B) model. This proceeds from the appreciation of gastroschisis as a congenital intestinal herniation (without cover or liver) within the primordial umbilical ring, mostly to the right side of a normally formed umbilical cord. Presently, it is unresolved whether this visceral prolapse represents failure of ring closure before return of the physiological hernia into the abdomen or rupture of the delicate amniotic/peritoneal membrane at the ring's edge to the right of the cord. Animal observations and experiments will be required to address this question effectively. If gastroschisis is, in fact, a primary malformation with the primordial umbilical ring as the developmental field involved, then homology implies potential gastroschisis in all amniotes with corresponding nourishment from yolk sac (aka omphalomesenteric) vessels going into the embryo and excretory products out via the ancient umbilical connection. It also implies homology of corresponding morphogenetic signal transduction cascades. We review the history of gastroschisis, its presumed pathogenesis, and the developmental biology of the amniotic umbilical ring from this perspective. Therefore, based on the animal and human evidence to date, we propose that gastroschisis is a primary midline malformation that involves the umbilical canal from amniotic to peritoneal space and its primordial umbilical ring, either through nonclosure or rupture of the membrane covering the area, mostly to the right, between the cord and the edge of the ring.


Assuntos
Parede Abdominal/embriologia , Evolução Biológica , Biologia do Desenvolvimento , Gastrosquise/etiologia , Cordão Umbilical/anormalidades , Cordão Umbilical/embriologia , Parede Abdominal/patologia , Desenvolvimento Embrionário , Gastrosquise/embriologia , Gastrosquise/patologia , Humanos , Lactente , Recém-Nascido
7.
Neonatal Netw ; 38(1): 17-26, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30679252

RESUMO

Nutrition for the infant with gastroschisis is a complex topic and there is not a lot of uniformity in the literature to formulate evidence-based care. This article discusses more recent findings in the literature as we search for an effective method of feeding these infants. Issues with growth and development, illustrating the variety of outcomes, are also addressed.


Assuntos
Técnicas de Fechamento de Ferimentos Abdominais/efeitos adversos , Gastrosquise , Terapia Nutricional/métodos , Complicações Pós-Operatórias/prevenção & controle , Gastrosquise/etiologia , Gastrosquise/fisiopatologia , Gastrosquise/cirurgia , Humanos , Recém-Nascido , Enfermagem Neonatal/educação , Diagnóstico Pré-Natal , Prognóstico
8.
J Matern Fetal Neonatal Med ; 32(14): 2346-2353, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29415587

RESUMO

OBJECTIVE: The objective of this study is to evaluate poor maternal nutrition, environmental exposures and vasoactive stimulants as potential risk factors for gastroschisis. METHODS: A case-control study was conducted among singleton pregnancies diagnosed in a tertiary teaching hospital in a 22-month period. Cases of gastroschisis were matched to controls at the time of diagnosis by race and maternal age. Demographics, periconceptual exposures, nutritional biomarkers, and illicit drug hair analysis were evaluated. Analyses were performed using conditional logistic regression. RESULTS: Thirty gastroschisis cases and 76 controls were studied with no associations observed for illicit drug use or serum levels of ferritin, iron, B6, B12, folate, or zinc. Neither prescription medication nor over the counter mediation use differed between cases and controls. Following adjustment for insurance, education, low BMI, and nulliparity, mothers of gastroschisis cases had an increased odds of alcohol use 1 month prior and/or during early pregnancy compared with controls, with adjusted odds ratio (OR) 3.19 (95% CI 1.01-11.61). CONCLUSIONS: Our findings suggest that further investigation of vasoactive stimulants such as alcohol is warranted in the search to identify risk factors for gastroschisis.


Assuntos
Gastrosquise/etiologia , Efeitos Tardios da Exposição Pré-Natal/sangue , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Projetos Piloto , Gravidez , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Fatores de Risco , Adulto Jovem
9.
Semin Pediatr Surg ; 27(5): 283-288, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30413258

RESUMO

The development of gastroschisis has long remained an area of interest and controversy. Successive theories about its pathogenesis are herein reviewed and discussed. Two historical assumptions, that omphalocele results from a persistent umbilical hernia, and that gastroschisis does not involve the umbilical cord, are dismissed. Therefore, one can envision gastroschisis for what it is, i.e. a ruptured physiological hernia. The causal agents for this intrauterine accident to occur are yet to be determined. Further bowel damage and complications can be explained by the mesenteric insult.


Assuntos
Gastrosquise/etiologia , Parede Abdominal/embriologia , Anormalidades Múltiplas/etiologia , Gastrosquise/embriologia , Humanos , Fatores de Risco
10.
Epidemiology ; 29(5): 721-728, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29863532

RESUMO

BACKGROUND: Gastroschisis, a congenital defect of the abdominal wall, occurs disproportionately more in offspring of young mothers and has been increasing in prevalence over the past decades. A wide range of exposures have been reported in association with an increased gastroschisis risk, independent of mother's age; many have also been correlated with stress responses. METHODS: We explored cumulative exposures to such stressor exposures among 1,261 mothers of gastroschisis cases and 10,682 mothers of controls in the National Birth Defects Prevention Study (1997-2011). We considered 16 exposures as stressors in the first trimester: fever, genitourinary infection, anti-herpetic medication use, injury, bronchodilator use, cigarette smoking, alcohol intake, illicit drug use, prescription opioid use, oral contraceptive use, interpregnancy interval < 12 months, residential move, aspirin use, ibuprofen use, venlafaxine use, and paroxetine use. RESULTS: Mothers of cases reported more stressor exposures than controls. For 1, 2, 3, and ≥ 4 stressor exposures compared with none, the age-adjusted odds ratios (95% confidence interval) were 1.3 (1.1, 1.6), 1.7 (1.4, 2.1), 2.5 (2.0, 3.1), and 3.6 (2.9, 4.4), respectively. When we weighted cumulative stress scores according to the magnitude of stressor-specific odds ratios, similar associations were observed. Cumulative stressor exposure did not account for the strong inverse association between age and gastroschisis risk. CONCLUSIONS: These findings show that gastroschisis risk appears to increase with accumulation of widely different types of exposures, consistent with the hypothesis that stress-induced inflammation might play an etiologic role.


Assuntos
Gastrosquise/etiologia , Exposição Materna/efeitos adversos , Adulto , Estudos de Casos e Controles , Feminino , Gastrosquise/epidemiologia , Humanos , Idade Materna , Exposição Materna/estatística & dados numéricos , Gravidez , Complicações na Gravidez/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia , Adulto Jovem
11.
Epidemiology ; 29(4): 571-573, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29634591

RESUMO

BACKGROUND: Gastroschisis is a congenital malformation that has been shown to be more common in younger mothers and appears to be increasing in prevalence in the United States and elsewhere. Epidemiologic data suggest a potential role of infection and recent studies report an association between maternal antibodies to human herpesviruses (HHV) and development of gastroschisis. METHODS: In this study, we examined newborn bloodspots from 50 children with gastroschisis and 50 healthy controls using a highly sensitive digital droplet polymerase chain reaction assay covering eight human herpesviruses [herpes simplex sirus 1/2, Epstein-Barr virus (HHV-4), cytomegalovirus (HHV-5), HHV-6A/B, HHV-7, and HHV-8], to examine the presence of herpesvirus DNA at birth, which would suggest in utero infection. RESULTS: One control tested positive for low-level cytomegalovirus infection. We found no evidence of an association between herpesvirus DNA in neonatal blood spots taken at birth and gastroschisis. CONCLUSIONS: Our results do not support direct involvement of herpesviruses in the etiology of gastroschisis. However, there are several limitations in our study, most notably the known induction of this congenital malformation early in pregnancy and our analysis of blood taken at birth. Therefore, we cannot conclude that herpesviruses play no role in the etiology of gastroschisis and further research is needed to better define this relationship.


Assuntos
Gastrosquise/etiologia , Infecções por Herpesviridae/sangue , Herpesviridae/isolamento & purificação , Herpesviridae/patogenicidade , California , Anormalidades Congênitas , Herpesviridae/genética , Humanos , Lactente , Reação em Cadeia da Polimerase , Vigilância da População
12.
Birth Defects Res ; 110(5): 429-442, 2018 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-29193865

RESUMO

BACKGROUND: Prevalence of gastroschisis has been increasing in the United States (US) since 1980s. Genital infection with Chlamydia has also been increasing in prevalence, particularly among younger women. The etiology of gastroschisis is unknown. Ongoing research suggests multiple causal factors may be involved, including Chlamydia infection in mothers during pregnancy. METHODS: Using birth certificate data from 2014 US vital records, we conducted a population-based case-control study to examine the association between prenatal Chlamydia exposure in young women (16-25 years of age) and gastroschisis in singleton offspring. Cases consisted of live births with gastroschisis, and controls had no major birth defects reported in their birth certificate. Logistic regression analysis was used to estimate crude and adjusted odds ratios (cOR and aOR) and 95% confidence intervals (CI). RESULTS: There were 809 cases (95.6% were isolated cases) and 1,260,293 controls. Chlamydia during pregnancy was reported in 4.5% of case and 3.6% control mothers (p = .21). Case mothers were significantly more likely to be younger (16-20 years of age) at the time of delivery compared to control mothers (p < .0001). We found no significant association between Chlamydia infection during pregnancy and gastroschisis (cOR = 1.24; 95% CI = 0.89-1.73 and aOR = 1.06; 95% CI: 0.66-1.70). CONCLUSION: With the caveat of possible misclassification of exposure and outcome variables in birth certificate data, we found no significant association between prenatal exposure to Chlamydia and gastroschisis in the offspring born to younger mothers. Future studies should refine measures by focusing on relevant risk period and biomarkers.


Assuntos
Infecções por Chlamydia , Gastrosquise , Doenças do Recém-Nascido , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Estudos de Casos e Controles , Infecções por Chlamydia/complicações , Infecções por Chlamydia/epidemiologia , Feminino , Gastrosquise/epidemiologia , Gastrosquise/etiologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido/epidemiologia , Doenças do Recém-Nascido/etiologia , Gravidez
13.
Birth Defects Res ; 109(8): 543-549, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28398639

RESUMO

BACKGROUND: Gastroschisis, a birth defect of the abdominal wall, is increasing in prevalence. The largest increase in prevalence has been observed among young mothers (<20 years). The prevalence of Chlamydia trachomatis (CT) infection is highest among young women and has also been increasing over time. The objective was to investigate the association between immunoglobulin G antibodies to Chlamydia trachomatis (CT) (anti-CT) and Chlamydial heat shock protein 60 (anti-CHP60) during pregnancy, and risk of gastroschisis among offspring. METHODS: We conducted a nested case-control study of 292 gastroschisis cases identified from the Congenital Malformations Register and 826 live born controls matched on age and birth year within the Finnish Maternity Cohort. Early pregnancy serum samples were used to categorize women by seropositivity to anti-CT and anti-CHP60. Women seronegative for anti-CT and anti-CHP60 served as the reference. We used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Effect measure modification by maternal age (<25 years, ≥25 years) was also assessed. RESULTS: Seropositivity to anti-CT (17.8% of cases vs. 16.0% of controls) or anti-CHP60 (23.6% of cases vs. 22.0% of controls) was not associated with gastroschisis. Although, the OR for seropositivity to anti-CT alone was slightly elevated (OR, 1.19; 95% CI, 0.73-1.94), specifically among young mothers (<25 years) (OR, 1.65; 95% CI, 0.81-3.37), the results were imprecise. CONCLUSION: Chlamydia infection, as measured by immunoglobulin G antibodies to CT and CHP60, is not associated with gastroschisis, however, our assays were not able to distinguish recent infection.Birth Defects Research 109:543-549, 2017.© 2017 Wiley Periodicals, Inc.


Assuntos
Anticorpos Antibacterianos/sangue , Infecções por Chlamydia/sangue , Chlamydia trachomatis/imunologia , Gastrosquise/etiologia , Complicações Infecciosas na Gravidez/sangue , Adulto , Estudos de Casos e Controles , Infecções por Chlamydia/epidemiologia , Estudos de Coortes , Feminino , Finlândia/epidemiologia , Gastrosquise/sangue , Gastrosquise/epidemiologia , Humanos , Imunoglobulina G/sangue , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Efeitos Tardios da Exposição Pré-Natal/sangue , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/etiologia , Fatores de Risco , Estudos Soroepidemiológicos , Adulto Jovem
14.
Clin. biomed. res ; 37(1): 25-32, 2017. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-833277

RESUMO

Objective: To know the profile of newborn diagnosed with gastroschisis and treated at a public hospital at Porto Alegre, southern Brazil. Method: A cross-sectional, descriptive, quantitative study was conducted to retrospectively analyze 54 medical records of neonates diagnosed with gastroschisis treated at the study hospital between January 2006 and January 2016. The analysis included all medical records of infants diagnosed with gastroschisis and born in the institution studied, as well as those who were transferred from other health institutions in the period examined. Medical records were searched through electronic consultation to the institution's Epidemiology Service, using the International Code of Diseases (ICD) 10 Q 793). Later, the files were accessed through the Medical Records and Statistics Service. Information was collected using a form containing the study variables. The data analysis was performed using SPSS software, version 21.0. The study complied with the ethical aspects of human research legislation. Results: The prevalence of gastroschisis was 0.11%, totaling 54 cases identified. Mean maternal age was 20.2 years; sex distribution was equal among newborns with the malformation; and 72.5% of cases had primary abdominal closure. Conclusion: The results for related causes and treatment, such as maternal age, drug use, and type of abdominal closure, were similar to findings from other studies on gastroschisis(AU)


Assuntos
Humanos , Gravidez , Recém-Nascido , Gastrosquise/epidemiologia , Gastrosquise/etiologia , Brasil/epidemiologia , Estudos Transversais , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos
15.
Am J Epidemiol ; 184(12): 902-912, 2016 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-27856447

RESUMO

Gastroschisis risk is highest in offspring of young women and is increasing in prevalence, suggesting that exposures that are increasingly common among younger females may be causal. Some infections by viruses in the herpes family are more common in the earlier childbearing years and have been increasing in prevalence over time. Data from the Finnish Maternity Cohort were linked to Finnish malformation and birth registers (1987-2012) for this study, a nested case-control study of mothers of offspring with gastroschisis and age-matched controls. Maternal antibody responses in early pregnancy (mean gestational age = 11.1 weeks) to Epstein Barr virus (EBV), herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), and cytomegalovirus were measured. Conditional logistic regression models were used to estimate odds ratios (and 95% confidence intervals) for high immunoglobulin reactivity. Odds ratios for high immunoglobulin M (IgM) reactivity to EBV-viral capsid antigen and HSV-1 or HSV-2 (as indicators of recent infection) were 2.16 (95% confidence interval (CI): 0.97, 4.79) and 1.94 (95% CI: 0.74, 5.12), respectively. For higher immunoglobulin G (IgG) reactivity to EBV-viral capsid antigen and HSV-2 IgG, odds ratios were 2.16 (95% CI: 0.82, 5.70) and 2.48 (95% CI: 1.50, 4.10), respectively. Reactivities to HSV-1 IgG, cytomegalovirus IgM, or cytomegalovirus IgG did not appear to increase gastroschisis risk. Primary EBV infection was not associated with gastroschisis, but observed associations with both IgM and IgG reactivities to EBV and HSV suggest that reactivations may be risk factors for it.


Assuntos
Infecções por Citomegalovirus/complicações , Infecções por Vírus Epstein-Barr/complicações , Gastrosquise/epidemiologia , Infecções por Herpesviridae/complicações , Complicações Infecciosas na Gravidez/virologia , Adulto , Anticorpos Antivirais/sangue , Estudos de Casos e Controles , Estudos de Coortes , Anormalidades Congênitas/epidemiologia , Infecções por Citomegalovirus/sangue , Infecções por Citomegalovirus/imunologia , Infecções por Vírus Epstein-Barr/sangue , Infecções por Vírus Epstein-Barr/imunologia , Feminino , Finlândia/epidemiologia , Gastrosquise/etiologia , Infecções por Herpesviridae/sangue , Infecções por Herpesviridae/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Imunoglobulina M/sangue , Imunoglobulina M/imunologia , Recém-Nascido , Modelos Logísticos , Masculino , Idade Materna , Registro Médico Coordenado , Razão de Chances , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Prevalência , Sistema de Registros , Fatores de Risco , Adulto Jovem
16.
Rev Chil Pediatr ; 87(5): 380-386, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-27476074

RESUMO

INTRODUCTION: Several communications have reported a significant increase in the prevalence of gastroschisis at birth in the last three decades. In many Countries it is referred to as "a pandemic strongly associated to low maternal age". OBJECTIVE: To verify if there has been a significant increase in the prevalence of gastroschisis at birth in Chile, and if this rate is associated with a low maternal age. PATIENTS AND METHODS: The study was performed using the ECLAMC data base from 26 Chilean Hospitals. Comparison between prevalence rates and maternal age categories were made using the X2 test or Fisher exact Test. The time series was studied comparing average tendencies using the Student t test and Wilcoxon-test. RESULTS: There were 721,901 newborns in the period 1982-2014, among which 107 were diagnosed with gastroschisis (1.48/10,000). Around three-quarters (75.7%) of them were born from mothers younger than 25. The mean maternal age was 21.6 years in mothers of children with gastroschisis, while the mean maternal age of all mothers from Chile was almost 28 years old. The gastroschisis prevalence at birth rate was constant at around 1/10,000 until 1994. From 1995 this rate has a significant increasing tendency of 0.1591 by year (P=.00714). This increase is about a 300% on average for the 1995-2014 period, compared with the previous one (P<.00001). CONCLUSION: There has been a significant increase in the gastroschisis prevalence at birth in Chile from 1995, and this anomaly is associated with a low maternal age.


Assuntos
Gastrosquise/epidemiologia , Idade Materna , Adolescente , Adulto , Chile/epidemiologia , Bases de Dados Factuais , Feminino , Gastrosquise/etiologia , Humanos , Recém-Nascido , Gravidez , Prevalência , Fatores de Risco , Estatísticas não Paramétricas , Adulto Jovem
17.
Am J Med Genet A ; 170(8): 2078-82, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27232448

RESUMO

The prevalence of gastroschisis has increased significantly in the past few decades. The strongest risks have been observed for women <25 years old or of low body mass index, and maternal diet also been proposed to be associated with risk. The objective of this study was to evaluate whether the risk of gastroschisis is associated with maternal dietary intake of phytoestrogens. The analysis includes data on mothers of 409 gastroschisis cases and 3,007 controls who delivered their infants from 2005 to 2010 and participated in the National Birth Defects Prevention Study, a multistate, population-based, case-control study. Detailed information was obtained from maternal telephone interviews that included a validated food frequency questionnaire. We conducted logistic regression analyses that included each phytoestrogen in its continuous form (to test for linearity) and quadratic form (to test for non-linearity), adjusted for maternal energy intake, age, BMI, race-ethnicity, and smoking in 1st trimester. Logistic regression analysis indicated that biochanin A, formonoetin, and coumestrol had a significant non-linear association with gastroschisis (P-value <0.05 for quadratic term). Lower intakes were associated with increased risk, with somewhat stronger but relatively modest associations at the lower end of the distribution; for example, the ORs for the 10th versus 50th percentiles ranged from 1.1 to 1.2. Associations were not significant for the other phytoestrogens. This study provides some evidence for association with certain phytoestrogens, after adjusting for covariates. The implications of our findings for clinical practice are uncertain pending other studies examining this association. © 2016 Wiley Periodicals, Inc.


Assuntos
Gastrosquise/epidemiologia , Gastrosquise/etiologia , Exposição Materna , Fitoestrógenos , Vigilância da População , Adulto , Estudos de Casos e Controles , Suplementos Nutricionais/efeitos adversos , Feminino , Humanos , Exposição Materna/efeitos adversos , Pessoa de Meia-Idade , Razão de Chances , Fitoestrógenos/efeitos adversos , Prevalência , Risco , Inquéritos e Questionários , Estados Unidos/epidemiologia , Estados Unidos/etnologia , Adulto Jovem
18.
Rev. centroam. obstet. ginecol ; 21(1): 15-17, ene.-mar. 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-835856

RESUMO

Se denomina gastrosquisis al prolapso prenatal del intestino hacia la cavidad amniótica a través de un pequeño defecto de todos los planos de la pared abdominal, ubicado generalmente a la derecha del cordón umbilical. Su prevalencia está incrementándose progresivamente en las últimas décadas, desde un caso por cada 10.000 nacidos vivos en los años setenta, hasta uno por cada 2.500 en la actualidad. La gastrosquisis suele presentarse de forma aislada y esporádica y asociada a malformaciones congénitas...


Assuntos
Humanos , Anormalidades Congênitas/diagnóstico , Anormalidades Congênitas/genética , Gastrosquise/complicações , Gastrosquise/etiologia , Técnicas
19.
J Perinatol ; 35(11): 930-4, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26378912

RESUMO

OBJECTIVE: To investigate the association between Chlamydia trachomatis (CT) infection seropositivity and gastroschisis. STUDY DESIGN: In this case-control study we enrolled pregnant women either prenatally diagnosed with gastroschisis (cases, n=33) or with a normal ultrasound (controls, n=66). Both groups attended the University of Utah's Maternal Fetal Medicine Diagnostic Center for their diagnostic ultrasound or because of a community obstetrician referral. Participants completed a structured interview on potential risk factors. Anti-CT immunoglobulin (IgG)1 and IgG3 were measured by a CT elementary body enzyme-linked immunosorbent assay. RESULT: Median age at sexual debut was lower and reported sexual partner number higher in cases compared with controls. Risk factors for gastroschisis included having ⩾ 3 sexual partners (odds ratio (OR)=3.3, 95% CI 1.2, 9.4), change in partner from the previous pregnancy (OR=3.6, 95% CI 0.9, 13.9) and anti-CT IgG3 seropositivity (age-adjusted OR=3.9, 95% CI: 1.1, 13.2). CONCLUSION: Anti-CT IgG3 seropositivity was associated with greater than a threefold risk for gastroschisis.


Assuntos
Infecções por Chlamydia/complicações , Chlamydia trachomatis/imunologia , Gastrosquise/etiologia , Imunoglobulina G/imunologia , Complicações Infecciosas na Gravidez/diagnóstico , Ultrassonografia Pré-Natal , Adulto , Estudos de Casos e Controles , Infecções por Chlamydia/diagnóstico , Intervalos de Confiança , Ensaio de Imunoadsorção Enzimática , Feminino , Gastrosquise/diagnóstico por imagem , Gastrosquise/epidemiologia , Idade Gestacional , Humanos , Incidência , Recém-Nascido , Masculino , Razão de Chances , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Medição de Risco , Testes Sorológicos , Estatísticas não Paramétricas , Estados Unidos/epidemiologia
20.
Birth Defects Res A Clin Mol Teratol ; 103(6): 536-43, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25846850

RESUMO

BACKGROUND: Although young maternal age has been identified as a risk factor for gastroschisis, its role remains undisclosed. To our knowledge, the differences between young mothers of infants with gastroschisis and young mothers of infants with other pregnancy outcomes have not been established. The aim of this work was to compare characteristics of young mothers whose newborn had gastroschisis with same aged mothers of malformed and nonmalformed control infants, diagnosed within the ECLAMC maternity hospital network. METHODS: Data base records of live and stillborn infants of one of three groups (with isolated gastroschisis, with 1 of 5 other isolated birth defects, and nonmalformed), and whose mothers were younger than 20 years, were selected. Secular trends were obtained for all birth defects; frequencies and odds ratios (OR) of demographic and reproductive variables were compared among the 3 groups. Significantly associated variables were adjusted with a multivariate regression. RESULTS: The association was higher with gastroschisis 1) than with other birth defects for African ancestry, smoking, adequate prenatal control and diagnosis 2) than with nonmalformed controls for maternal illnesses and alcohol 3) and than both for previous pregnancy loss and medication, mainly sex hormones. After adjustment, only previous pregnancy loss maintained its significance when compared with malformed (OR = 2.34; 1.37-3.97; P = 0.002), as well as with nonmalformed (OR = 3.43; 2.07-5.66; P < 0.001) controls. CONCLUSION: A previous pregnancy loss was identified as the main risk factor for gastroschisis, while an increased use of sex hormones, perhaps related to the previous loss, could trigger a disruptive mechanism, due to their thrombophilic effect.


Assuntos
Aborto Espontâneo/epidemiologia , Gastrosquise/epidemiologia , Gastrosquise/etiologia , Hormônios Esteroides Gonadais/efeitos adversos , Idade Materna , Adolescente , Argentina/epidemiologia , Anormalidades Congênitas/epidemiologia , Feminino , Humanos , Recém-Nascido , Razão de Chances , Gravidez , Análise de Regressão , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA