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2022-01-01
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- IOC - Artigos de Periódicos [12141]
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GASTROSCHISIS: INTERNATIONAL EPIDEMIOLOGY AND PUBLIC HEALTH PERSPECTIVES
Pandemias
Adolescente
Prevalência de nascimento
Defeitos da parede do corpo
Tendência crescente
Baixa idade materna
Pandemia
Megalocele
Body wall defects
Birth prevalence
Increasing trend
Low maternal age
Teenage
Pandemic
Affilliation
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Epidemiologia de Malformações Congênitas. Rio de Janeiro, RJ. Brasil / Instituto Universitario CEMIC. Buenos Aires, Argentina / National Research Councils of Argentina. Buenos Aires, Argentina / Conselho Nacional de Desenvolvimento Científico e Tecnológico. Brasília, DF, Brasil.
Centre of the International Clearinghouse for Birth Defects Surveillance and Research. Rome, Italy.
Universidade Federal do Rio de Janeiro. Genética. Rio de Janeiro, RJ, Brasil / Diretor adjunto do ECLAMC.
Centre of the International Clearinghouse for Birth Defects Surveillance and Research. Rome, Italy.
Universidade Federal do Rio de Janeiro. Genética. Rio de Janeiro, RJ, Brasil / Diretor adjunto do ECLAMC.
Abstract
Gastroschisis offers the intriguing epidemiological situation of a pandemic, strongly associated with very low maternal age. Identifying gastroschisis, and distinguishing it from the other abdominal wall defects, is theoretically easy but difficult in practice. The baseline birth prevalence of gastroschisis before the pandemic was approximately 1 in 50,000 births and has increased since between 10- and 20-fold. In many populations worldwide, it is still increasing. Such increasing prevalence and the association with very low maternal age are well proven, but the interaction between these two findings remains unknown. Geographic gradients (decreasing prevalence from North to South) are clear in Continental Europe and suggestive in Britain and Ireland. Gastroschisis seems more frequent in Caucasians compared to African Blacks and Orientals, and in Northern compared to Southern Europeans. These observations indicate the need for investigating gene–environment interactions. Since the global human situation is marked by inequalities among as well as within countries, the medical care and public health impact of gastroschisis varies widely among regions and social strata. The postnatal benefits of prenatal diagnosis of gastroschisis include family awareness; adequate planning of delivery with alerted obstetrical, pediatric, and surgical staff; optimal risk categorization, and personalized protocol for action. The increasing prevalence of gastroschisis combined with improved medical techniques to reduce morbidity and mortality are also increasing the burden and costs of this anomaly on health systems.
Keywords in Portuguese
GastrosquisePandemias
Adolescente
Prevalência de nascimento
Defeitos da parede do corpo
Tendência crescente
Baixa idade materna
Pandemia
Keywords
GastroschisisMegalocele
Body wall defects
Birth prevalence
Increasing trend
Low maternal age
Teenage
Pandemic
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