title: Geospatial clustering of gastroschisis in Poland: Data from the Polish Registry of Congenital Malformations (PRCM).
abstract: OBJECTIVE
  The aims of this study were: to evaluate the prevalence of abdominal wall defects in the Polish population, to analyze temporal trends in the prevalence, to identify areas (clusters) of high risk of abdominal wall defects, and to characterize, with respect to epidemiology, children with abdominal wall defects and their mothers in the area defined as a cluster.
  
  
  METHODS
  We used isolated congenital malformations (gastroschisis Q79.3 and omphalocele Q79.2 according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10, the extended version)) data reported to the Polish Registry of Congenital Malformations (PRCM) over the years 1998- 2008 based on the population of 2 362 502 live births. We analyzed 11 administrative regions of Poland with complete epidemiologic data.
  
  
  RESULTS
  Of 11 regions, 2 had a significantly higher standardized prevalence of isolated gastroschisis: Dolnośląskie (1.7/10 000 live births, p = 0.0052) and Śląskie (1.9/10 000 live births, p < 0.0001). Furthermore, within the region of Dolnośląskie, we defined a clear prevalence of the isolated gastroschisis cluster (p = 0.023). We comprehensively examined demographic and socio-economic risk factors for abdominal wall defects in this area, and we found that these factors failed to account for the cluster.
  
  
  CONCLUSIONS
  We identified a distinct prevalence cluster for isolated gastroschisis, although a precise reason for the disease clustering in this region remains unknown. Cluster identification enables more focused research aimed at identification of specific factors with teratogenic effects.
authors.affiliation: Poznan University of Medical Sciences, Poznań, Poland (Department of Medical Genetics). akiryluk@ump.edu.pl.
authors.forename: Anna
authors.initials: A
authors.lastname: Materna-Kiryluk
authors.affiliation: Poznan University of Medical Sciences, Poznań, Poland (Department of Computer Science and Statistics). basia@ump.edu.pl.
authors.forename: Barbara
authors.initials: B
authors.lastname: Więckowska
authors.affiliation: Poznan University of Medical Sciences, Poznań, Poland (Department of Preventive Medicine).
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Wiśniewska
authors.affiliation: Wroclaw Medical University, Wrocław, Poland (Department and Clinic of Neonatology).
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Czyżewska
authors.affiliation: Medical University of Silesia, Katowice, Poland (Department of Pediatrics in Zabrze).
authors.forename: Urszula
authors.initials: U
authors.lastname: Godula-Stuglik
authors.affiliation: Medical University of Silesia, Katowice, Poland (Department of Neonatology).
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Baumert
authors.affiliation: Poviat Hospital, Nysa, Poland (Neonatal Unit).
authors.forename: Ryszard
authors.initials: R
authors.lastname: Margol
authors.affiliation: Poznan University of Medical Sciences, Poznań, Poland (Department of Medical Genetics).
authors.forename: Anna
authors.initials: A
authors.lastname: Latos-Bieleńska
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D020139:Gastroschisis / Q000453:epidemiology*; D006554:Hernia, Umbilical / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D012959:Socioeconomic Factors; D013029:Space-Time Clustering; D055815:Young Adult
keywords: congenital malformations; epidemiology; gastroschisis; omphalocele; scan statistic; spatial and temporal clusters