Nutrition/Obesity
Maternal Dietary Intakes and Gastroschisis in Offspring Julie M. Petersen* Julie Petersen Petersen Petersen Petersen Petersen Petersen Petersen Petersen University of Nebraska Medical Center
Gastroschisis is a serious congenital abdominal wall defect in which the intestines herniate outside the body. While young maternal age is a strong risk factor, few modifiable factors are known. We examined associations between maternal dietary intake and gastroschisis using the Slone Birth Defects Study, a North American case–control design (1998–2015). Cases included 273 pregnancies affected by isolated gastroschisis. Controls were 2,591 live borns without major anomalies, frequency-matched by center. Mothers completed standardized interviews within 6 months postpartum. Diet for the 6 months before pregnancy (proxy for early prenatal intake) was assessed with a modified Willett food frequency questionnaire. Quartiles for 28 macro- and micronutrients were derived based on the control distribution and energy-adjusted using the residual method. Gastroschisis associations with each nutrient were estimated using LASSO logistic regression, adjusting for age, race, education, income, parental relationship status, BMI, pregnancy intention, smoking, alcohol consumption, oral contraceptive use, nonsteroidal anti-inflammatory drug use, folic acid supplementation, parity, and the other nutrients. Nutrients were identified as relevant based on adjusted odds ratios (aORs), permutation-based changes in AUC, and Shapley values. Compared with the lowest quartile, moderate glutamic acid (aOR 0.57, 95% CI 0.34–0.97), vitamin E (0.72, 0.49–1.0), and polyunsaturated fat (0.80, 0.53–1.0), and high magnesium (0.60, 0.33–1.0) and calcium (0.76, 0.47–1.0), were associated with reduced odds of gastroschisis. Higher cryptoxanthin intake was associated with increased odds (1.29, 1.0–1.9). These results suggest a potential nutritional mechanism. While most nutrients showed protective benefits, finding high cryptoxanthin (in yellow/orange fruits/vegetables) was associated with increased odds was surprising. Replication and clarification of clinically relevant intake thresholds are needed.