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CME Credit Offered
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Abstract Award
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Poster Session 3

(872) Decreasing Trend of Gastroschisis Prevalence in the United States between 2014 and 2022

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Nikan Zargarzadeh, MD

    Research Fellow
    Boston Children's Hospital, Harvard Medical School
    Boston, Massachusetts, United States

    • Coauthor(s)

  • May Abiad, MD (she/her/hers)

    Postdoctoral Research Fellow
    Maternal Fetal Care Center, Boston Children's Hospital
    Boston, Massachusetts, United States

  • KM

    Kevin Moss

    Department of Biostatistics and Health Data Science, Indiana University School of Medicine, IN, USA
    Department of Biostatistics and Health Data Science, Indiana University School of Medicine, IN, USA, Indiana, United States

  • Erin Perrone, MD (she/her/hers)

    Clinical Associate Professor
    Department of Pediatric Surgery, University of Michigan, C.S Mott’s Children’s Hospital, MI, USA
    Ann Arbor, Michigan, United States

  • BG

    Brian W. Gray, MD

    Associate Professor of Surgery
    Department of Pediatric Surgery, Indiana University School of Medicine
    Indianapolis, Indiana, United States

  • TB

    Terry Buchmiller, MD

    Department of Pediatric Surgery, Boston Children's Hospital, Harvard Medical School
    Boston, Massachusetts, United States

  • Kjersti M. Aagaard, MD, PhD

    Medical Director, HCA Healthcare and HCA Research Institute
    Boston Children’s Hospital, Division of Fetal Medicine and Surgery, Boston, MA; HCA Healthcare and HCA Healthcare Research Institute, Nashville, TN; HCA Texas Maternal Fetal Medicine, Houston, TX; Baylor College of Medicine and Texas Children's Hospital, Houston, TX
    Tomball, Texas, United States

  • Alireza A. Shamshirsaz, MD (he/him/his)

    Department Director, Professor of Surgery
    Fetal Surgeon Chief, Division of Fetal Medicine and Surgery Director of the Maternal Fetal Care Center Director of the Perinatal Surgery Fellowship Professor of Surgery, Boston Children’s Hospital Harvard Medical School
    Boston, Massachusetts, United States

  • Hiba J. Mustafa, MD (she/her/hers)

    Director of Fetal Surgery, Director of Placenta Accreta Spectrum Program
    Indiana University and Riley Children's Hospital
    Indianapolis, IN, United States

Objective: To investigate the prevalence trend and characteristics of congenital gastroschisis in the United States between 2014 and 2022

Study Design: A cross-sectional retrospective analysis of the Centers for Disease Control and Prevention database for United States live births between 2014 and 2022. Neonatal singleton live births with documented isolated gastroschisis were included, and neonates with other major congenital anomalies and known chromosomal abnormalities were excluded. Prevalence per 10,000 live births along with 95% confidence intervals were estimated, with comparisons to unaffected birth rates in same aged cohorts.

Results: Among 32,088,301 singleton live births (2014–2022), 6,804 cases of isolated gastroschisis were identified (point prevalence: 2 per 10,000 live births). Starting in 2018, a significant decline in gastroschisis prevalence was observed, decreasing from 2.86 in 2014 to 1.55 per 10,000 live births in 2022 (p< 0.001). The risk of gastroschisis was significantly higher in teen and nulliparous gravidae, among non-Hispanic indigenous Americans, with maternal tobacco use, and among vulnerable populations (underweight, < 12th grade education, Medicaid). The declining rate in neonates with gastroschisis, compared to neonates without gastroschisis, is attributable to declines in births among gravidae under 25 (p = 0.02), with significant declines in prevalence of other attributable maternal factors (p< 0.001). Despite early reports suggesting a mediating effect of COVID-19, there was no significant difference of the pandemic on the declining trend rate.



Conclusion: This comprehensive analysis of over 32 million births highlights a notable decline in the prevalence of neonates with gastroschisis, which is attributable to a declining birth rate in the highest at-risk strata of vulnerable gravidae. Given recent increases in birth rates in these same populations, our findings anticipate a reverse of the trend of declining gastroschisis disease prevalence. Further research is necessary to understand the role of access to reproductive care in rates of common congenital anomalies.