A declining incidence of gastroschisis parallels trends in maternal smoking rates in the United States.

INTRODUCTION

Previous studies demonstrated that smoking is a risk factor for gastroschisis. Since smoking rates among young adults have declined, we hypothesized that this would be associated with a concurrent decrease in gastroschisis rates among live births in the United States.

METHODS

The Department of Health and Human Services (HHS) dataset encompasses all live births in the US. Data from 2017 to 2023 was compiled and the daily number of cigarettes smoked by the mother prior to conception was included as an independent variable. The primary outcome was a diagnosis of gastroschisis in the newborn.

RESULTS

A total 25,836,224 live births with complete information were identified between 2017 and 2023. 5121 newborns (∼2:10,000 births) were diagnosed with gastroschisis, with 858 (16.75 %) born to mothers with a history of smoking prior to pregnancy. Maternal smoking rates decreased significantly from 9.4 % in January, 2017 to 3.5 % in December, 2023 (p < 0.01). Incidence of gastroschisis decreased from 3.1 cases per 10,000 births in January, 2017 to 1.6 cases per 10,000 births in December, 2023 (p < 0.01). Mothers with any history of smoking three months prior to conception were significantly more likely to deliver a newborn with gastroschisis (OR = 2.82, 95 % CI 2.62-3.04, p < 0.001).

DISCUSSION: There is an association between maternal smoking and gastroschisis diagnosis. Additionally there has been a decline maternal smoking, which paralleled a similar decline in annual gastroschisis rates in the United States.