Increase in Life Threatening Birth Defect - Gastroschisis

Cases of a serious birth defect of the abdominal wall called gastroschisis continue to increase, according to a January 22, 2016 Centers for Disease Control and Prevention (CDC) report. CDC researchers found that over 18 years, the prevalence of gastroschisis more than doubled in the United States. More research is needed to understand what is causing the increase.


Babies with gastroschisis are born with their intestines extruding from their body through an opening in the abdominal wall. Sometimes other organs, such as the stomach and liver, may also be involved. This birth defect requires surgery to return the abdominal organs into the baby’s body and repair the abdominal wall. Even after surgery, infants with gastroschisis can have problems eating or digesting food. In some cases, gastroschisis can be life threatening. Overall, about 2,000 U.S. babies are born each year with gastroschisis.


Gastroschisis was most prevalent among mothers younger than 20 years of age. The largest increase in this birth defect – 263 percent from 1995 to 2012 – was among babies born to non-Hispanic black mothers age 20 or younger. Gastroschisis occurs early during pregnancy when the muscles that make up the baby’s abdominal wall do not form correctly. A hole occurs which allows the intestines and other organs to extend outside of the body, usually to the right side of the belly button. Because the intestines are not covered in a protective sac and are exposed to the amniotic fluid, the bowel can become irritated, causing it to shorten, twist, or swell.


“It concerns us that we don’t know why more babies are being born with this serious birth defect. Public health research is urgently needed to figure out the cause and why certain women are at higher risk of having a baby born with gastroschisis,” said Coleen Boyle, Ph.D., director of the CDC’s National Center on Birth Defects and Developmental Disabilities.


The CDC study analyzed data from 14 states: Arizona, Arkansas, California, Colorado, Georgia, Iowa, Kentucky, New Mexico, New York, North Carolina, Oklahoma, Rhode Island, Texas, and Utah. The study compared the prevalence of gastroschisis among babies born to mothers of different ages in 1995-2005 to those born in 2006-2012. The greatest increases in prevalence occurred among younger, black mothers, but the prevalence in black mothers remains lower than in white and Hispanic mothers.


In addition to the finding that the largest increase in gastroschisis was among black non-Hispanic teen mothers, CDC researchers found that:


  • Most cases of gastroschisis occurred in mothers younger than age 20 years;
  • The increase in gastroschisis births among teen mothers is not related to the number of live births for teen mothers, which actually declined during the same period.
  • From 1995-2012, the number of babies born with gastroschisis increased among mothers of every age and racial/ethnic group studied.


“While gastroschisis has become more common among non-Hispanic white and Hispanic mothers, this study shows the greatest increases were among younger, non-Hispanic black mothers. We must continue to monitor changes in this birth defect to identify risk factors contributing to these increases and hopefully start to reverse the trend,” said Peggy Honein, Ph.D., M.P.H., chief, Birth Defects Branch, CDC National Center on Birth Defects and Developmental Disabilities.


The causes of gastroschisis among most infants are unknown. Some babies have gastroschisis because of a change in their genes or chromosomes. Gastroschisis might also be caused by a combination of genes and other factors, such as the things the mother comes in contact with in the environment or what the mother eats or drinks, or certain medicines she uses during pregnancy. CDC researchers have found that women who consumed alcohol or were smokers were more likely to have a baby with gastroschisis. A 2008 review noted that risk factors associated with gastroschisis, after adjusting for maternal age, have included lower socioeconomic status, lower body mass index and other indicators of poor nutrition (lower intake of high quality nutrients and dietary fats), smoking, use of illicit drugs, alcohol, or analgesic medications, and genitourinary infections.


The CDC is working to address birth defects, including gastroschisis, through tracking and research. The CDC tracks birth defects through several state tracking systems and regional programs. It also supports and collaborates with the National Birth Defects Prevention Network (NBDPN). The CDC funds the Centers for Birth Defects Research and Prevention, which collaborate on large studies such as the National Birth Defects Prevention Study (births 1997-2011) and the Birth Defects Study to Evaluate Pregnancy exposures (BD-STEPS) (beginning with births in 2014). These studies work to identify factors that increase the risk for birth defects.


Like many families affected by birth defects, the CDC wants to find out what causes these defects. Developing factors that are more common among babies with birth defects furthers the understanding of these causes.


See the CDC Announcement


See the CDC Report


See also Medical Law Perspectives, August 2015 Report: Pediatrician Liability for Childhood Disease Complications


See also Medical Law Perspectives, January 2015 Report: Mothers, Infants, and Obstetrical Injuries: Labor and Delivery Liability


See the Medical Law Perspectives February 23, 2015, Blog: Florida’s No-Fault Compensation System for Severe Birth Injury Claims Fails Again