What caused the birth defect cluster last year on babies born in Reno?

November 6, 2:41 PMSacramento Nutrition ExaminerAnne Hart

Gastroschisis is a birth defect that occurs early in pregnancy, characterized by incomplete closure of the baby’s abdominal wall. It is most common in births by young women, age 21 or younger. Babies with this birth defect are born with part of their intestines outside their bodies, which necessitates repair of the abdominal wall in the first week of life.

According to the press release, “While this is one of the largest documented gastroschisis clusters that I have found, and it is still a concern that requires further investigation, we are pleased the cluster seems to have subsided," said Leslie Elliott, assistant professor of epidemiology at the University of Nevada, Reno School of Community Health Sciences and principal investigator of the study. “And, most importantly, because mothers sought prenatal care, our excellent physicians in the community were able to diagnose the condition during pregnancy, and then plan for and provide the immediate care required at birth to correct it.”

In this study, “case mothers,”mothers who had babies with gastroschisis during the study period, were 13 times more likely to report having a sore throat during early pregnancy, and 17 times more likely to report having a chest cold in early pregnancy than “control-group mothers,” those who did not have babies with gastroschisis during the study period. In addition, case mothers were nine times more likely than control-group mothers to report having taken over-the-counter medications for these infections during pregnancy.

This study is the first to find an association between gastroschisis and methamphetamine use, specifically. Case mothers were seven times more likely than control-group mothers to report methamphetamine use before pregnancy.

It is also important to note that some case mothers in the cluster did NOT report any of the identified risk factors. Elliott was senior epidemiologist of chronic diseases with the Washoe County Health District and an adjunct faculty member of the University at the time the cluster surfaced.

“Local public health nurses and perinatologists noticed an increase in the number of babies being diagnosed with the defect in Washoe County, and reported this to us at the Epidemiology Division of the Washoe County Health District,” Elliott explained.

Key to success of the investigation was the cooperation of mothers in the community, both those who had given birth to babies with gastroschisis and those who had given birth to babies without the defect.

According to the press release,“This was an exemplary case of public health practitioners and nurses, local physicians, patients and University researchers working together to address an important health issue in our community,” Elliott said.

Elliott said that even though the cluster seems to be subsiding, further investigation is needed, according to the press release. “Why did this cluster occur in Washoe County when we know that these same risk factors exist in many communities across the country?” she said. “The study calls for further research regarding possible associations between gastroschisis and infections during pregnancy, use of medications during pregnancy, methamphetamine and recreational drug use prior to or during pregnancy, lifestyle factors, and community-specific characteristics.”

Elliott is working with colleagues at the University to develop a larger case-control study of gastroschisis and other birth defects in Washoe County that could be instrumental in confirming the findings of the cluster investigation, as well as identifying additional risk factors.

Nevada’s land-grant university founded in 1874, the University of Nevada, Reno has an enrollment of nearly 17,000 students. The University is home to one the country’s largest study-abroad programs and the state’s medical school, and offers outreach and education programs in all Nevada counties.