LATEBREAKER
Perinatal & Pediatric
Recent reductions in gastroschisis prevalence in the United States and Puerto Rico largely explained by population-level decline in younger maternal age at live birth Julie M. Petersen* Julie Petersen Jeremy Schraw Mahsa Yazdy Martha Werler
Background: Gastroschisis is an abdominal wall congenital anomaly. The strongest risk factor is young maternal age. Over several decades, gastroschisis had been increasing, but North American data suggest a recent decrease. We estimated population-based time trends in gastroschisis prevalence in the United States (US) and Puerto Rico 2000–2020 and indirectly examined whether the recent shift may be attributed to population-level declines in younger maternal age.
Methods: We pooled US state/territory summary-level data from 17 active surveillance systems and 29 passive (or combination) systems or birth certificates, the latest of which became public in 2024. We estimated crude prevalence per 10,000 live births and 95% confidence intervals (CI) within 5-year periods with moving averages every 2 years. We estimated the expected prevalence of gastroschisis based on the distribution of maternal age among US live births (<20, 20–24, ≥25 years) and previously published maternal age-based prevalence estimates.
Results: Gastroschisis prevalence increased since 2000, peaked in 2008–2012, and then declined, with an average reduction of ~4.8% every 2 years. The same trends occurred when restricted to active systems but absolute prevalence estimates were higher (2008–2012: 5.44, 95% CI 5.23, 5.65; 2016–2020: 4.47, 95% CI 4.27, 4.67, among systems with all years available). The proportion of all US births among individuals <20 years decreased (2000: 11.8%, 2020: 4.4%). Applying prior prevalence estimates based on maternal age yielded near identical expected gastroschisis prevalence as observed. If these trends continue, we project gastroschisis prevalence will be the same as 2000–2004 by 2026.
Conclusions: These data confirm that gastroschisis prevalence decreased in recent years and provide indirect support that the reduction largely reflects the decline in US births among younger maternal ages, rather than a substantial change in gastroschisis risk among younger individuals.
