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Spatial variability of gastroschisis in Canada, 2006–2011: An exploratory analysis

  • Quantitative Research
  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

OBJECTIVES: Gastroschisis is a serious birth defect of the abdominal wall that is associated with mortality and significant morbidity. Our understanding of the factors causing this defect is limited. The objective of this paper is to describe the geographic variation in incidence of gastroschisis and characterize the spatial pattern of all gastroschisis cases in Canada between 2006 and 2011. Specifically, we aimed to ascertain the differences in spatial patterns between geographic regions and identify significant clusters and their location.

METHODS: The study population included 641 gastroschisis cases from the Canadian Pediatric Surgery Network (CAPSNet) database, a population-based dataset of all gastroschisis cases in Canada. Cases were geocoded based on maternal residence. Using Statistics Canada live-birth data as a denominator, the total prevalence of gastroschisis was calculated at the provincial/territorial levels. Random effects logistic models were used to estimate the rates of gastroschisis in each census division. These rates were then mapped using ArcGIS. Cluster detection was performed using Local Indicators of Spatial Association (LISA).

RESULTS: There is significant spatial heterogeneity of the rate of gastroschisis across Canada at both the provincial/territorial and census-division level. The Yukon, Northwest Territories and Prince Edward Island have higher overall rates of gastroschisis relative to other provinces/territories. Several census divisions in Alberta, Manitoba, Saskatchewan, Ontario, Northwest Territories and British Columbia demonstrated case “clusters”, i.e., focally higher rates in discrete areas relative to surrounding areas.

CONCLUSIONS: There is clear evidence of spatial variation in the rates of gastroschisis across Canada. Future research should explore the role of area-based variables in these patterns to improve our understanding of the etiology of gastroschisis.

Résumé

OBJECTIFS: Le laparoschisis est une anomalie congénitale grave de la paroi abdominale associée à la mortalité et à une importante morbidité. Nos connaissances des facteurs à l’origine de cette malformation sont limitées. Nous avons cherché à décrire la variation spatiale de l’incidence du laparoschisis et à caractériser la structure spatiale de tous les cas de laparoschisis survenus au Canada entre 2006 et 2011. Plus précisément, nous avons voulu vérifier les différentes structures spatiales des régions géographiques et repérer les grappes significatives et leur emplacement.

MÉTHODE: La population étudiée comptait 641 cas de laparoschisis trouvés dans la base de données du Réseau canadien de chirurgie pédiatrique (CAPSNet), un fichier de données populationnelles de tous les cas de laparoschisis au Canada. Les cas ont été géocodés d’après le lieu de résidence de la mère. En utilisant les données de Statistique Canada sur les naissances vivantes comme dénominateur, nous avons calculé la prévalence totale du laparoschisis par province ou territoire et par secteur du recensement. Ces taux ont ensuite été cartographiés à l’aide d’ArcGIS. La détection des concentrations de cas a été effectuée à l’aide d’indicateurs locaux d’associations spatiales.

RÉSULTATS: Il existe une hétérogénéité spatiale importante des taux de laparoschisis au Canada, tant à l’échelle provinciale et territoriale qu’à celle des secteurs du recensement. Le Yukon, les Territoires du Nord-Ouest et l’Île-du-Prince-Édouard ont des taux globaux de laparoschisis plus élevés que les autres provinces et territoires. Plusieurs secteurs du recensement en Alberta, au Manitoba, en Saskatchewan, en Ontario, dans les Territoires du Nord-Ouest et en Colombie-Britannique présentent des grappes de laparoschisis, contrairement à leurs contreparties.

CONCLUSIONS: Il existe des preuves manifestes de variation spatiale des taux de laparoschisis au Canada. Les recherches futures devraient explorer le rôle des variables régionales dans cette configuration, afin d’améliorer nos connaissances de l’étiologie du laparoschisis.

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Authors and Affiliations

  1. Toronto Public Health, Toronto, ON, Canada

    Kate L. Bassil PhD

  2. Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, ON, Canada

    Junmin Yang MSc

  3. Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada

    Laura Arbour MSc, MD

  4. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

    Rahim Moineddin PhD

  5. Departments of Surgery and Community Health Sciences, University of Calgary, Calgary, AB, Canada

    Mary E. Brindle MD, MPH

  6. Department of Geography, Ryerson University, Toronto, ON, Canada

    Emily Hazell MSA

  7. Department of Surgery, University of British Columbia, Vancouver, BC, Canada

    Erik D. Skarsgard MSc, MD

  8. Division of Medical Sciences, University of Victoria, Victoria, BC, Canada

    Laura Arbour MSc, MD

Authors
  1. Kate L. Bassil PhD
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  2. Junmin Yang MSc
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  3. Laura Arbour MSc, MD
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  4. Rahim Moineddin PhD
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  5. Mary E. Brindle MD, MPH
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  6. Emily Hazell MSA
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  7. Erik D. Skarsgard MSc, MD
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Corresponding author

Correspondence to Erik D. Skarsgard MSc, MD.

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Conflict of Interest: None to declare.

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Bassil, K.L., Yang, J., Arbour, L. et al. Spatial variability of gastroschisis in Canada, 2006–2011: An exploratory analysis. Can J Public Health 107, e62–e67 (2016). https://doi.org/10.17269/cjph.107.5084

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  • DOI: https://doi.org/10.17269/cjph.107.5084

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