Association between the congenital abdominal wall defects (CAWD) with early maternal age in the years 2001-2017 and the temporal tendency of the prevalence in the years 2011- 2017 in the cities of Bogotá and Cali. Omphalocele and gastroschisis are the most common CAWD: in the United States the prevalence is 1.86 and 4.49 per 10,000 live births respectively. Between 1999 and 2007, the prevalence of omphalocele increased by 11%, whereas the prevalence of gastroschisis increased by 83%.

1. Association between the congenital abdominal wall defects
(CAWD) with early maternal age in the years 2001-2017 and
the temporal tendency of the prevalence in the years 2011-
2017 in the cities of Bogotá and Cali
C. Tovar Sanchez1, C. López-Burbano2, S. Puentes Mahecha3,J. Holguín4,
P. Hurtado-Villa2, I. Zarante1
1Institute of Human Genetics, Pontificia Universidad Javeriana, Bogotá
2 Faculty of Health Sciences, Pontificia Universidad Javeriana, Cali
3Secretaria de Salud de Bogotá, Congenital Malformations Surveillance Programme of Bogotá
4Secretaria de Salud Pública Municipal de Cali, Congenital Birth Defects Surveillance Programme of Cali
45th ICBDSR Annual Meeting
Prague, Czech Republic

2. Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana
Prevalence and Epidemiology
1. The prevalence of selected major birth defects in the United States. Kirby RS Semin Perinatol. 2017;41(6):338.
2. Prevalence trends of selected major birth defects: A multi-state population-based retrospective study, United States, 1999 to 2007. St Louis AM, Kim K, Browne ML, Liu G, Liberman RF,
Nembhard WN, Canfield MA, Copeland G, Fornoff J, Kirby RS, National Birth Defects Prevention Network
3. Prevalence, prenatal diagnosis and survival of gastroschisis. Fillingham A, Rankin J Prenat Diagn. 2008;28(13):1232.
Omphalocele and
gastroschisis are the most
common CAWD: in the
United States the prevalence
is 1.86 and 4.49 per 10,000
live births respectively.1
CAWD: congenital abdominal wall defects
Between 1999 and 2007, the
prevalence of omphalocele
increased by 11%, whereas
the prevalence of
gastroschisis increased by
83%.2-3

3. Prevalence and Epidemiology
4. Castilla EE, Mastroiacovo P, Orioli IM. 2008. Gastroschisis: International epidemiology and public health perspectives. Am J Med Genet Part C Semin Med Genet 148C:162–179.
5. Feldkamp ML, Botto LD, Byrne JLB,Krikov S, Carey JC. 2016. Clinical presentation and survival in a populationbased cohort of infants with gastroschisis in Utah, 1997–2011. Am J
Med Genet Part A 170A:306–315.
Gastroschisis was a very rare
anomaly until the 1960s, when the
prevalence started increasing.
For the last three decades
gastroschisis has been in the
epidemiological situation of
pandemic.4
Typically gastroschisis is considered
an isolated birth defect.
A population-based cohort study of
Infants with gastroschisis in Utah,
1997–2011 confirmed the high
frequency of isolated occurrence
(84%).5
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana

4. Prevalence and Epidemiology
In a study in the city of
Bogota 282,523 births were
analyzed. A rate of 2.1 and
1.2 * 10,000 births were
calculated for gastroschisis
and omphalocele,
respectively.6
At the San Ignacio
University Hospital, the
average maternal age was
23.7 years. 65% of the
patient´s mothers were
under 24 years.7
6. Risk factors associated with congenital malformations of surgical management in the monitoring program of congenital malformations of the city of Bogotá. Correa, Catalina, Zarante, Ignacio et al.
Nueva Granada University. 2013
7. Caracterización de los pacientes, tratamiento y complicaciones más frecuentes de los recién nacidos con gastrosquisis y onfalocele manejados en la unidad de recién nacidos del Hospital
Universitario San Ignacio: experiencia de 10 años. Bertolotto AM, Córdoba MA, Vargas YA, Guzmán PC, Álvarez AN. Univ Med. 2016;57(3):323-31.
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana

5. Objectives
Trends of CAWD during 2011-2017 in the cities of Bogotá and Cali,
Colombia.
Estimate the association between early maternal age and prevalence of
CAWD during 2001-2017.
CAWD: congenital abdominal wall defects
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana

6. Methods:
*CAWD: congenital abdominal wall defects
*SIVIGILA: Public Health Surveillance System.
*CMSP: Congenital Malformations Surveillance Programme. Bogotá, Colombia.
*CBDSP: Congenital Birth Defects Surveillance Programme. Cali, Colombia.
The temporal trend of
prevalence for CAWD
The SIVIGILA database
was used in both cities
from 2011-2017
Prevalence for CAWD
per 10,000 births was
calculated
Association between
early maternal age (≤18y)
and prevalence of CAWD
The databases of the
CMSP and CBDSP were
used in both cities during
2001-2017
Odds ratios (OR)s were
estimated along with
their respective 95%
confidence intervals (CI)s
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana

7. Results: Temporal Trend of CAW
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana
3,00
3,60
2,10
3,80
4,80
5,70
6,50
7,86
1,56 1,56
2,46
1,26
5,58
4,34
0,00
1,00
2,00
3,00
4,00
5,00
6,00
7,00
8,00
9,00
2011 2012 2013 2014 2015 2016 2017
RATE*10.000BIRTHS
YEAR
TEMPORAL TREND OF CAWD
BOG
CALI
*CAWD: congenital abdominal wall defects.

8. *CAWD: congenital abdominal wall defects
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana
2011 2012 2013 2014 2015 2016 2017
GASTROSCHISIS RATE 2,2 3,1 1,7 2,8 2,8 4,4 4,1
OMPHALOCELE RATE 1,08 0,40 0,37 0,90 1,72 1,29 1,85
TOTAL CAWD RATE 3,23 3,47 2,02 3,69 4,54 5,68 5,94
0,0
1,0
2,0
3,0
4,0
5,0
6,0
7,0
RATE*10.000BIRTHS TEMPORAL TREND OF CAWD (BOGOTÁ AND CALI)
TOTAL
AVERAGE
TOTAL CAWD 4,16
GASTROSCHISIS 3.06
OMPHALOCELE 1.10

9. Results: Association between early maternal age (≤18y)
and prevalence of CAWD
Databases of the
CMSP and CBDSP
between 2001-2017
472.645 in Bogotá 62.198 in Cali
534.843 births
were evaluated
*CAWD: congenital abdominal wall defects.
*CMSP: Congenital Malformations Surveillance Programme. Bogotá, Colombia.
*CBDSP: Congenital Birth Defects Surveillance Programme. Cali, Colombia.
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana

10. Results: Association between early maternal age (≤18y)
and prevalence of CAWD
*Were not taken into account for analysis
MATERNAL
AGE (years)
CASES
TOTAL
BIRTHS
RATE
*10.000
≤ 18 49 55.099
8,89
19-33 130 357.871
3,63
≥ 34 14 72.898
1,92
NO DATA* 9 48.975
1,84
TOTAL 202 534.843
3,78
MATERNAL
AGE (years)
TOTAL
CAWD GASTROSCHISIS OMPHALOCELE TOTAL BIRTHS
≤ 18 49 42 7 55.099
19-33 130 95 35 357.871
≥ 34 14 1 13 72.898
TOTAL 193 138 55 485.868
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana
*CAWD: congenital abdominal wall defects.

11. Results: Association between early maternal age (≤18y)
and prevalence of CAWD
≤ 18 YEARS > 18 YEARS
CASES CONTROLS CASES CONTROLS ORs
GASTROSCHISIS 42 55.057 96 430.673 3,42 (2,38 - 4,92)
OMPHALOCELE 7 55.092 48 430.721 1,14 (0,52 - 2,52)
TOTAL CAWD 49 55.050 144 430.625 2,66 (1,92 - 3,68)
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana
*CAWD: congenital abdominal wall defects.

12. Discussion:
Similar to the published
literature, we observed an
increase in prevalence of
CAWD over time in Bogotá,
but not in Cali; however, the
sample size in Cali was
smaller.
We reaffirm the relationship
between early maternal age
and the presence of CAWD,
with a rate of 8.9 in mothers
≤18y vs 2.7 in those > 18y.
*CAWD: congenital abdominal wall defects.
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana

13. Conclusions:
Poor prenatal care, low
socioeconomic stratum, low
schooling, ingestion of alcoholic
beverages and cigarette smoking
have been linked as risk factors
for congenital malformations
which are more frequent in
lower maternal ages.
Continued focus on the study of
risk factors that contribute to
the increase of CAWD,
surveillance and develop health
policies that allow integral care
in specialized centers for patients
with CAWD.
*CAWD: congenital abdominal wall defects.
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana

14. catherin.tovar@javeriana.edu.co
Secretaría de Salud Bogotá - Cali
Pontificia Universidad Javeriana