The role of maternal stress in early pregnancy in the aetiology of gastroschisis: An incident case control study

Stephen R Palmer, Annette Evans, Hannah K. Broughton, Simon Huddart, Mark Drayton, Judith Rankin, Elizabeth S. Draper, Alan Cameron, Shantini Paranjothy* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticle

17 Citations (Scopus)
1 Downloads (Pure)

Abstract

Objective: The incidence of gastroschisis, a congenital anomaly where the infant abdominal wall is defective and intestines protrude from the abdominal cavity, is increasing in many countries. The role of maternal stress in some adverse birth outcomes is now well established. We tested the hypothesis that major stressful life events in the first trimester are risk factors for gastroschisis, and social support protective, in a case-control study in the United Kingdom. Methods: Gastroschisis cases and three controls per case (matched for maternal age) were identified at routine 18-20 week fetal anomaly ultrasound scan, in 2007-2010. Face to face questionnaire interviews were carried out during the antenatal period (median 24 weeks gestation) asking about serious stressful events and social support in the first trimester. Data were analysed using conditional logistic regression. Results: Two or more stressful life events in the first trimester (adjusted OR 4.9; 95% CI 1.2-19.4), and moving address in the first trimester (aOR 4.9; 95% CI 1.7-13.9) were strongly associated with risk of gastroschisis, independent of behavioural risk factors including smoking, alcohol, and poor diet. Perceived availability of social support was not associated with reduced risk of gastroschisis (aOR 0.8; 95% CI 0.2-3.1). Conclusions: Stressful maternal life events in the first trimester of pregnancy including change of address were strongly associated with a substantial increase in the risk of gastroschisis, independent of stress related high risk behaviours such as smoking, alcohol consumption and poor diet. This suggests that stress pathways are involved in the aetiology of gastroschisis.
Original languageEnglish
Article number e80103
Number of pages9
JournalPloS ONE
Volume8
Issue number11
DOIs
Publication statusPublished - 8 Nov 2013

Keywords

  • Pregnancy
  • Alcohol consumption
  • Finance
  • Smoking habits
  • Diet
  • Folic acid
  • Congenital anomalies
  • Nutrition

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