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The prevalence of gastroschisis

Figure 1: A newborn baby with gastroschisis

Figure 1: A newborn baby with gastroschisis

Abdominal wall defects are among the commonest structural defects in babies. Gastroschisis is one type and it is characterised by a defect to the right of the umbilicus, with an associated protrusion of the intestines and other organs through the opening (Figure 1).

Babies born with this condition are more likely to be premature and their growth may be affected. They nearly always need immediate surgery usually followed by a prolonged stay in a neonatal unit. Gastroschisis is a distressing condition for parents but the outlook for the baby, following treatment, is usually very good with over 90% of cases surviving with few long-term problems. The majority of babies with gastroschisis are diagnosed before birth, which allows time for parental counselling, careful monitoring of the pregnancy and planning of treatment after the birth.

Over the past 30 years, there has been a slow increase in the prevalence of gastroschisis worldwide. Reported rates from the European Surveillance of Congenital Anomalies (EUROCAT) in 2002 were around 2.0 per 10,000 total births. Similar rates have been reported by the National Congenital Anomaly System (NCAS) for England and Wales with 2.1 per 10,000 births in 2003.

Recent data from BINOCAR, the British Isles Network of Congenital Anomaly Registers, however, has shown that the prevalence of gastroschisis from the UK Congenital Anomaly Registers is somewhat higher at 4.0 per 10,000 total births for the period 2002 to 2004 (Figure 2). There has been a significant increase over the past 10 years from 2.5 to 4.4 per 10,000 total births over the period 1994 to 2003 (Figure 2).

As the prevalence of gastroschisis is low, the year-on-year variation within each regional register can be wide. The three-year average prevalence rates are shown in Table 1. There was a four-fold difference in gastroschisis prevalence across the different registers, ranging from 1.6 to 6.2 per 10,000 total births.

Table 1: Average three-year prevalence of gastroschisis ranked highest to lowest

RegionPrevalence rate (per 10,000 births)95% confidential interval
Wales6.24.6 - 7.8
Northern5.23.7 - 6.7
Glasgow4.92.3 - 7.4
Mersey4.73.2 - 6.3
Former Trent4.73.7 - 5.7
West Midlands4.23.2 - 5.1
Wessex3.32.0 - 4.5
South West3.32.4 - 4.2
Oxford2.40.3 - 4.5
North West Thames1.61.0 - 2.2
All BINOCAR registers4.03.6 - 4.4

Source: BINOCAR registers 2002-2004

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