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Violence against Women and Gastroschisis: A Case-Control Study
Paediatric Environmental Health Speciality Unit, Department of Paediatrics, Hospital Clinic University Virgen of Arrixaca, Murcia, 30120, Spain
Georgetown University Medical Center, Washington, DC 20007, USA
Direction of Healthcare System, Murcia Health Service, Regional Ministry of Health, Murcia, 30008, Spain
* Author to whom correspondence should be addressed.
Received: 26 June 2013; in revised form: 29 September 2013 / Accepted: 29 September 2013 / Published: 17 October 2013
Abstract: Background: Gastroschisis, a birth defect characterized by herniated fetal abdominal wall, occurs more commonly in infants born to teenage and young mothers. Ischemia of the vascular vitelline vessels is the likely mechanism of pathogenesis. Given that chronic stress and violence against women are risk factors for cardiovascular disease we explored whether these may represent risk factors for gastroschisis, when they occur during pregnancy. A case-control study was conducted, with 15 incident cases of children born with gastroschisis in the Region of Murcia, Spain, from December 2007 to June 2013. Forty concurrent controls were recruited at gestation weeks 20–24 or post-partum. All mothers of cases and controls completed a comprehensive, in-person, ‘green sheet’ questionnaire on environmental exposures. Results: Mothers of children with gastroschisis were younger, smoked more cigarettes per week relative to controls, were exposed to higher amounts of illegal drugs, and suffered from domestic violence more frequently than the controls. Multivariable logistic regression analysis highlights periconceptional ‘gender-related violence’ (OR: 16.6, 95% CI 2.7 to 101.7) and younger maternal age (OR 1.1, 95% CI 1.0–1.3). Conclusions: Violence against pregnant women is associated with birth defects, and should be studied in more depth as a cause-effect teratogenic. Psychosocial risk factors, including gender-based violence, are important for insuring the health and safety of the pregnant mother and the fetus.
Keywords: gastroschisis; risk factors; domestic violence; health promotion; case-control study
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Ortega-García, J.A.; Soldin, O.P.; Sánchez-Sauco, M.F.; Cánovas-Conesa, A.; Gomaríz-Peñalver, V.; Jaimes-Vega, D.C.; Perales, J.E.; Cárceles-Alvarez, A.; Martínez-Ros, M.T.; Ruiz, D. Violence against Women and Gastroschisis: A Case-Control Study. Int. J. Environ. Res. Public Health 2013, 10, 5178-5190.
Ortega-García JA, Soldin OP, Sánchez-Sauco MF, Cánovas-Conesa A, Gomaríz-Peñalver V, Jaimes-Vega DC, Perales JE, Cárceles-Alvarez A, Martínez-Ros MT, Ruiz D. Violence against Women and Gastroschisis: A Case-Control Study. International Journal of Environmental Research and Public Health. 2013; 10(10):5178-5190.
Ortega-García, Juan A.; Soldin, Offie P.; Sánchez-Sauco, Miguel F.; Cánovas-Conesa, Alicia; Gomaríz-Peñalver, Virtudes; Jaimes-Vega, Diana C.; Perales, Joseph E.; Cárceles-Alvarez, Alberto; Martínez-Ros, Maria T.; Ruiz, Daniel. 2013. "Violence against Women and Gastroschisis: A Case-Control Study." Int. J. Environ. Res. Public Health 10, no. 10: 5178-5190.