A low prepregnancy body mass index is a risk factor for an offspring with gastroschisis

A mother's prepregnancy obesity has been suggested as a risk factor for having offspring with an abdominal wall defect. We evaluated this hypothesis among 104 cases of gastroschisis-a severe birth defect of the abdominal wall most prevalent in infants of young women-and 220 controls with no defect. Using Quetelet's index (QI = weight in kg/height in m(2)) as a measure of body mass, we found a higher risk of gastroschisis (odds ratio (OR) = 3.2; 95% confidence interval (CI) = 1.4-7.3) for underweight mothers (QI <18.1 kg/m(2)) and a lower risk (OR = 0.2; 0.05-0.9) for overweight mothers (QI >28.3 kg/m(2)) as compared with mothers of normal weight. As ar was correlated to height, with the correlation varying according to mother's ethnicity and age, we adjusted for these factors in the analysis; the adjusted values approximated the unadjusted values. Evaluation of QI as a continuous variable showed that, for every unit increase in QI, the risk for gastroschisis decreased by about 11%. Sociodemographic, pregnancy, and nutrient factors did not confound the association. These results suggest that low prepregnancy body mass rather than obesity is a risk factor for gastroschisis.