Ecological Analysis of Gastroschisis Incidence Decline in Liaoning, China, 2006-2016  Open Access

Ruiping Liu, Fengyu Zhang, Claude Hughes, Jianxin Li

November 20, 2020



Background: A gastroschisis incidence decline has recently been reported in Liaoning, China, from 2006-2015; we suspect that this decline could be associated with the fall in industrial manufacturing activities.

Methods: The outcome variable, gastroschisis incidence, was from a previously published report. The industrial manufacturing activities were measured by relative job participation and production in the primary and secondary economic sectors, and the corresponding data were collected in 14 cities from 2005 to 2015. The general linear model and a random-effect Poisson regression model were performed to assess the association and time-series trend of gastroschisis with the manufacturing activities.

Results: The relative job participation in the first economic sector was marginally associated with gastroschisis incidence in 2006 (p=0.070), but more significantly associated (Beta=-0.040; p=0.014) in the cross-sectional and time-series analysis with one-year lag in the outcome variable.

Conclusion: The gastroschisis incidence decline in Liaoning is likely due to the reduced job participation in manufacturing and heavy industry, which might be an indication of reduced risk exposure associated with the industrial manufacturing activities.


Gastroschisis incidence, ecological analysis, random-effect Poisson regression model, job participation

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Licensee Global Clinical and Translational Research. This is an open-access article distributed under the terms and conditions of the Creative Commons Attribution License (CCBY4.0, by/4.0/),which permits unrestricted use, distribution, and repro-duction in any medium provided the original work is properly cited.

How to cite this article

Liu R, Zhang F, C Hughes C, Li J. Ecological Analysis of Gastroschisis Incidence Decline in Liaoning, China, 2006 to 2015. Glob Clin Transl Res. 2020; 2 (4):100-106. DOI:10.36316/gcatr.02.0036.


1.        Kilby MD. The incidence of gastroschisis. BMJ. 2006;332 (7536):250-1.

2.        Hughes C, Adibe O. The increasing prevalence of gastroschisis: associated factors, possible mechanisms, and potential mitigative interventions. Glob Clin Transl Res. 2019; 1(1):4-17. DOI:10.36316/gcatr.01.0002

3.        Castilla EE, Mastroiacovo P, Orioli IM. Gastroschisis: international epidemiology and public health perspectives. Am J Med Genet C Semin Med Genet. 2008;148C(3):162-79.

4.        Chabra S, Gleason CA, Seidel K, Williams MA. Rising prevalence of gastroschisis in Washington State. J Toxicol Environ Health A. 2011;74(5):336-45.

5.        Kirby RS, Marshall J, Tanner JP, Salemi JL, Feldkamp ML, Marengo L, et al. Prevalence and correlates of gastroschisis in 15 states, 1995 to 2005. Obstet Gynecol. 2013;122(2 Pt 1):275-81.

6.        Short TD, Stallings EB, Isenburg J, O'Leary LA, Yazdy MM, Bohm MK, et al. Gastroschisis Trends and Ecologic Link to Opioid Prescription Rates - the United States, 2006-2015. MMWR Morb Mortal Wkly Rep. 2019;68(2):31-6.

7.        Jones AM, Isenburg J, Salemi JL, Arnold KE, Mai CT, Aggarwal D, et al. Increasing Prevalence of Gastroschisis--14 States, 1995-2012. MMWR Morb Mortal Wkly Rep. 2016;65(2):23-6.

8.        Emusu D, Salihu HM, Aliyu ZY, Pierre-Louis BJ, Druschel CM, Kirby RS. Gastroschisis, low maternal age, and fetal morbidity outcomes. Birth Defects Res A Clin Mol Teratol. 2005; 73(10):649-54.

9.        Anderson JE, Cheng Y, Stephenson JT, Saadai P, Stark RA, Hirose S. Incidence of Gastroschisis in California. JAMA Surg. 2018;153(11):1053-5.

10.     Reece AS, Hulse GK. Gastroschisis and Autism-Dual Canaries in the Californian Coalmine. JAMA Surg. 2019.

11.     Anderson J, Hirose S. Gastroschisis and Autism-Dual Canaries in the Californian Coalmine-Reply. JAMA Surg. 2019.

12.     Li N, Chen YL, Li J, Li LL, Jiang CZ, Zhou C, et al. Decreasing prevalence and time trend of gastroschisis in 14 cities of Liaoning Province: 2006-2015. Sci Rep. 2016;6:33333.

13.     Xu L, Li X, Dai L, Yuan X, Liang J, Zhou G, et al. Assessing the trend of gastroschisis prevalence in China from 1996 to 2007 using two analytical methods. Birth Defects Res A Clin Mol Teratol. 2011;91(3):177-84.

14.     Zhang TN, Gong TT, Chen YL, Wu QJ, Zhang Y, Jiang CZ, et al. Time trends in the prevalence and epidemiological characteristics of neural tube defects in Liaoning Province, China, 2006-2015: A population-based study. Oncotarget. 2017; 8(10):17092-104.

15.     Yang W, Carmichael SL, Shaw GM. Folic acid fortification and prevalence of neural tube defects, orofacial clefts, and gastroschisis in California, 1989 to 2010. Birth Defects Res A Clin Mol Teratol. 2016;106(12):1032-41.

16.     Sun S. Study on the relationship between industrial structure and employment structure of Liaoning Province. Journal of Shenyang University of Technology. 2018;11(1):57-61