Case-control Study of a Gastroschisis Cluster in Nevada

Objective: To identify potential risk factors associated with a sudden increase in gastroschisis cases in northern Nevada. Design: Case-control study. Setting: Medical centers and a pregnancy care center in Reno, Nevada. Participants: Participants (n = 14) were women who gave birth to infants with gastroschisis at either of the 2 medical centers in Reno, Nevada, from April 5, 2007, through April 4, 2008. Controls (n = 57) were selected from the same pregnancy center providing perinatal care to the cases and were matched 4: 1 to the case mothers by maternal date of birth within 1 year. Main Exposures: Environmental exposures and illnesses during pregnancy. Outcome Measures: Association of gastroschisis with illnesses, medications, or environmental exposures. Results: Gastroschisis was associated with the use of methamphetamine(odds ratio [OR], 7.15; 95% confidence interval [CI], 1.35-37.99) or any vasoconstrictive recreational drug (methamphetamine, amphetamine, cocaine, ecstasy) (OR, 4.46; 95% CI, 1.21-16.44) before pregnancy. When we limited self-reported illnesses to those occurring during the first trimester of pregnancy, chest colds(OR, 16.77; 95% CI, 1.88-150.27) and sore throats (OR, 12.72; 95% CI, 1.32-122.52) were associated with gastroschisis. Conclusions: These findings add strength to the hypothesis that use of methamphetamine and related drugs is a risk factor for gastroschisis and raise questions about the risks associated with infections.