title: Spatial analysis of gastroschisis in the National Birth Defects Prevention Study.
abstract: BACKGROUND
  Gastroschisis is a birth defect where loops of bowel are protruding from the abdominal wall at birth. Previous research has suggested that gastroschisis cases can occur in clusters. The objective of this study was to identify if there were areas of elevated gastroschisis risk using data from the National Birth Defects Prevention Study (NBDPS), 1997 through 2007.
  
  
  METHODS
  We obtained data on cases (n = 371) through population-based birth defects surveillance systems in Arkansas, California, and Utah; controls (n = 2359) were selected from the same geographic areas as cases. Mothers were interviewed on demographic information and exposures during pregnancy, including residential history. We used first trimester maternal addresses and generalized additive models to create a continuous map surface of odds ratios (OR) by smoothing over latitude and longitude. Permutation tests were used to assess whether location of maternal residence was important and identify locations with statistically significant ORs.
  
  
  RESULTS
  In Arkansas, adjusted ORs in the southwest corner were 2.0 and the global deviance was not statistically significant (p-value: 0.57). Adjusted ORs for California indicated areas of increased risk with ORs 1.3 (p-value: 0.34). In Utah, the adjusted ORs were elevated (OR: 2.4) in the south-eastern corner of the study area (p-value: 0.34).
  
  
  CONCLUSIONS
  The results of this study, while not statistically significant, suggest there were spatial variations in gastroschisis births. We cannot rule out that these variations were due to edge effects or residual confounding.
authors: Slone Epidemiology Center at Boston University, Boston, Massachusetts.
authors: Mahsa M
authors: MM
authors: Yazdy
authors: Slone Epidemiology Center at Boston University, Boston, Massachusetts.
authors: Martha M
authors: MM
authors: Werler
authors: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.
authors: Marcia L
authors: ML
authors: Feldkamp
authors: Stanford University, Stanford, California.
authors: Gary M
authors: GM
authors: Shaw
authors: Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Arkansas Children's Hospital Research Institute, Little Rock, Arkansas.
authors: Bridget S
authors: BS
authors: Mosley
authors: Program in Public Health, University of California, Irvine, California.
authors: Veronica M
authors: VM
authors: Vieira
mesh_terms: D001131:Arkansas / Q000453:epidemiology; D002140:California / Q000453:epidemiology; D005260:Female; D020139:Gastroschisis / Q000453:epidemiology*; D005843:Geography; D006801:Humans; D007407:Interviews as Topic; D016017:Odds Ratio; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy; D015995:Prevalence; D062211:Spatio-Temporal Analysis; D014589:Utah / Q000453:epidemiology
keywords: congenital abnormalities; gastroschisis; spatial analysis