Is the prevalence of abdominal wall defects in the Hudson Valley Region of New York State a public health concern?

Background:Nationwide epidemiologic studies demonstrate an increasing trend in prevalence for gastroschisis and a declining trend for omphalocele.Racial and ethnic disparities have been suggested but evidence is inconclusive. Objective:To determine prevalence of gastroschisis and omphalocele in the Hudson Valley Region (HVR) of NYS by race and ethnicity. Methods:NYS DOH Vital Statistics and Congenital Malformations Registry data obtained by race and ethnicity from 1992 to 2001 across 7 counties of HVR.Live-birth cases of gastroschisis and omphalocele diagnosed up to 2 years of age were included. Poisson regression, adjusting for population size, was used for analysis of relative risks (RR). Results:There were 58 infants with either gastroschisis (29) or omphalocele (29) identified from a birth population of 2,354,280.Over the ten year period overall prevalence of abdominal wall defects (AWD) was 2.5/10,000 live births, 1.2/10,000 live births with gastroschisis and 1.2/10,000 live births with omphalocele. There was no significant evidence of temporal trend for either gastrochisis [RR=0.81, 95% CI 0.39-1.69] or omphalocele [RR=0.53, 95% CI 0.0.24-1.13].However, there were regional differences in prevalence among counties.There was a significantly higher risk of AWD for Orange County [prevalence 3.2/10,000 live births; RR=1.98, 95% CI 1.03-3.79] as compared to other counties.There was no evidence of racial/ethnic variations among AWD for Non-Hispanic White, Non-Hispanic Black, Hispanic and Other categories. Conclusions:In the HVR the temporal trend of abdominal wall defects was inconsistent with reports from other populations.Regional differences among counties may have implications for public health surveillance and prenatal monitoring.