Case-control study of self reported genitourinary infections and risk of gastroschisis: findings from the national birth defects prevention study, 1997-2003

doi:10.1136/bmj.39567.509074.25

BMJ 2008;336:1420-1423 (21 June), doi:10.1136/bmj.39567.509074.25 (published 16 June 2008)

Research

Case-control study of self reported genitourinary infections and risk of gastroschisis: findings from the national birth defects prevention study, 1997-2003

Marcia L Feldkamp, epidemiologist¹^,2, Jennita Reefhuis, epidemiologist³, James Kucik, health scientist³, Sergey Krikov, research analyst ¹^,2, Andy Wilson, research analyst¹^,2, Cynthia A Moore, clinical geneticist³, John C Carey, paediatric geneticist¹^,2, Lorenzo D Botto, medical epidemiologist¹^,2

¹ Division of Medical Genetics, Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT 84132, USA , ² Utah Birth Defect Network, Utah Department of Health, Utah, ³ National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia

Correspondence to: M L Feldkamp marcia.feldkamp{at}hsc.utah.edu

Objective To assess the association between genitourinary infectionsin the month before conception to the end of the first trimesterandgastroschisis.

Design Case-control study with self reported infections froma computer assisted telephone interview.

Setting National birth defects prevention study, a multisite,population based study including 10 surveillance systems forbirth defects in the United States.

Participants Mothers of 505 offspring with gastroschisis and4924 healthy liveborn infants as controls.

Main outcome measure Adjusted odds ratios for gastroschisiswith 95% confidence intervals.

Results About 16% (n=81) of case mothers and 9% (n=425) of controlmothers reported a genitourinary infection in the relevant timeperiod; 4% (n=21) and 2% (n=98) reported a sexually transmittedinfection and 13% (n=67) and 7% (n=338) reported a urinary tractinfection, respectively. Case mothers aged <25 years reportedhigher rates of urinary tract infection alone and in combinationwith a sexually transmitted infection compared with controlmothers. In women who reported both types of infection, therewas a greater risk of gastroschisis in offspring (adjusted oddsratio 4.0, 95% confidence interval 1.4 to 11.6).

Conclusion There is a significant association between self reportedurinary tract infection plus sexually transmitted infectionjust before conception and in early pregnancy and gastroschisis.

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