title: Violence against women and gastroschisis: a case-control study.
abstract: BACKGROUND
  Gastroschisis, a birth defect characterized by herniated fetal abdominal wall, occurs more commonly in infants born to teenage and young mothers. Ischemia of the vascular vitelline vessels is the likely mechanism of pathogenesis. Given that chronic stress and violence against women are risk factors for cardiovascular disease we explored whether these may represent risk factors for gastroschisis, when they occur during pregnancy. A case-control study was conducted, with 15 incident cases of children born with gastroschisis in the Region of Murcia, Spain, from December 2007 to June 2013. Forty concurrent controls were recruited at gestation weeks 20-24 or post-partum. All mothers of cases and controls completed a comprehensive, in-person, 'green sheet' questionnaire on environmental exposures.
  
  
  RESULTS
  Mothers of children with gastroschisis were younger, smoked more cigarettes per week relative to controls, were exposed to higher amounts of illegal drugs, and suffered from domestic violence more frequently than the controls. Multivariable logistic regression analysis highlights periconceptional 'gender-related violence' (OR: 16.6, 95% CI 2.7 to 101.7) and younger maternal age (OR 1.1, 95% CI 1.0-1.3).
  
  
  CONCLUSIONS
  Violence against pregnant women is associated with birth defects, and should be studied in more depth as a cause-effect teratogenic. Psychosocial risk factors, including gender-based violence, are important for insuring the health and safety of the pregnant mother and the fetus.
authors.affiliation: Paediatric Environmental Health Speciality Unit, Department of Paediatrics, Hospital Clinic University Virgen of Arrixaca, Murcia, 30120, Spain. ortega@pehsu.org.
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Ortega-García
authors.forename: Offie P
authors.initials: OP
authors.lastname: Soldin
authors.forename: Miguel Felipe
authors.initials: MF
authors.lastname: Sánchez-Sauco
authors.forename: Alicia
authors.initials: A
authors.lastname: Cánovas-Conesa
authors.forename: Virtudes
authors.initials: V
authors.lastname: Gomaríz-Peñalver
authors.forename: Diana Carolina
authors.initials: DC
authors.lastname: Jaimes-Vega
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Perales
authors.forename: Alberto
authors.initials: A
authors.lastname: Cárceles-Alvarez
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Martínez-Ros
authors.forename: Daniel
authors.initials: D
authors.lastname: Ruiz
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D005260:Female; D020139:Gastroschisis / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D013030:Spain; D019966:Substance-Related Disorders; D014754:Violence; D055815:Young Adult