Torfs C P, Velie E M, Oechsli F W, Bateson T F, Curry C J
California Birth Defects Monitoring Program, Emeryville 94608.
Teratology. 1994 Jul;50(1):44-53. doi: 10.1002/tera.1420500107.
Gastroschisis, an abdominal wall defect, most often occurs in infants of young mothers. To identify risk factors for gastroschisis, we conducted a case-control study in the population surveyed by the California Birth Defects Monitoring Program (CBDMP). From structured questionnaire data, we compared sociodemographic, reproductive, and lifestyle factors for 110 mothers of infants with gastroschisis with those for 220 age-matched mothers of normal infants. Univariate matched-pair analysis showed significant associations of gastroschisis with mother's education, yearly family income, marital status, a history of mother's mother smoking, mother's father's absence from home during the mother's youth, more than one elective abortion, a short interval between menarche and first pregnancy, siblings from different fathers, and use of either a recreational drug (either cocaine, amphetamine, marijuana, or LSD), alcohol, or tobacco during the trimester preceding pregnancy. For cocaine, amphetamine, and marijuana, use of more than one drug showed a stronger association than single drug use. The association was stronger if both parents used drugs. Although many variables were correlated, odds ratios (OR) were significant (95% confidence intervals) in multivariate conditional logistic analysis for: yearly family income < $10,000 [OR = 4.34 (1.54, 12.22)] or $10,000-$49,999 [OR = 3.93 (1.43, 10.80)]; mother's mother's smoking status not known [OR = 3.99 (1.66, 9.56)]; mother's father's absence from home during her youth [OR = 3.11 (1.14, 8.46)]; and drug use by mother [OR = 2.21 (1.21, 4.03)], father [OR = 1.66 (1.02, 2.69)], or both [OR = 3.05 (1.48, 6.28)]. The best predictive model explained 32% of the deviance. Young, socially disadvantaged women with a history of substance use were at highest risk for a child with a gastroschisis.
腹裂是一种腹壁缺陷，最常发生在年轻母亲所生的婴儿中。为了确定腹裂的风险因素，我们在加利福尼亚出生缺陷监测项目（CBDMP）调查的人群中进行了一项病例对照研究。根据结构化问卷数据，我们比较了110名腹裂婴儿母亲与220名年龄匹配的正常婴儿母亲的社会人口统计学、生殖和生活方式因素。单因素配对分析显示，腹裂与母亲的教育程度、家庭年收入、婚姻状况、外祖母吸烟史、母亲年轻时外祖父不在家、多次选择性流产、初潮与首次怀孕间隔时间短、同父异母的兄弟姐妹以及怀孕前三个月使用娱乐性药物（可卡因、安非他命、大麻或麦角酸二乙酰胺）、酒精或烟草有关。对于可卡因、安非他命和大麻，使用多种药物的关联比单一药物使用更强。如果父母双方都使用药物，这种关联更强。尽管许多变量相互关联，但在多因素条件逻辑分析中，以下因素的优势比（OR）具有显著性（95%置信区间）：家庭年收入<一万美元[OR = 4.34（1.54，12.22）]或一万至四万九千九百九十九美元[OR = 3.93（1.43，10.80）]；外祖母吸烟状况未知[OR = 3.99（1.66，9.56）]；母亲年轻时外祖父不在家[OR = 3.11（1.14，8.46）]；母亲[OR = 2.21（1.21，4.03）]、父亲[OR = 1.66（1.02，2.69）]或父母双方[OR = 3.05（1.48，6.28）]使用药物。最佳预测模型解释了32% 的偏差。有药物使用史的年轻、社会经济地位低下的女性生出腹裂患儿的风险最高。
