Factores de riesgo hereditarios y socioeconómicos para labio o paladar hendido no asociados a un síndrome en México: estudio de casos y controles pareado

Abstract

Introduction.From an epidemiological point of view, non-syndromic orofacial clefts are the most common oral congenital deformities worldwide. Objective. Family histories were traced and socioeconomic risk factors were identified for nonsyndromic cleft lip with or without cleft palate. Material and methods. A case-control study was carried out with 208 cases of non-syndromic cleft lip with or without cleft palate, and matched by age and sex with 416 controls. Cases were patients attending a referral clinic from 2002 through 2004 in Campeche, Mexico. A questionnaire was administered to collect sociodemographic and socioeconomic variables as well as familial background relevant to non-syndromic cleft lip with or without cleft palate. Conditional logistic regression models were used; adjusted odds ratios and 95% confidence intervals were calculated. Results. In the multivariate model, the following risk factors were identified: 1) low socioeconomic status; 2) birth in the southern region of Campeche state; 3) home delivery or delivery in a publicly funded hospital; 4) occurrence of prior non-syndromic cleft lip with or without cleft palate cases in the father's or mother's family: 5) having a sibling with non-syndromic cleft lip with or without cleft palate; 6) the proband having another malformation, and 7) a history of infections during pregnancy. Prenatal care consisting of vitamin supplementation was a protective factor for non-syndromic cleft lip with or without cleft palate (odds ratio=0.29). Conclusions. A "social gradient in health" was seen to link oral malformation with diet components, and several socioeconomic and socio-demographic factors broadly encompassed in low socioeconomic status. Further characterization of risk factors will guide the assemblage of a pro-active counseling and prevention program for families at risk for non-syndromic cleft lip and cleft palate.

A discriminant analysis prediction model of non-syndromic cleft lip with or without cleft palate based on risk factors

“…Consistent with previous studies, a low family income [14], not attending premarital medical examinations [35], family history [14–16], maternal occupational hazards exposure [21, 22] and paternal occupational hazards exposure [23] selected as predictors were significantly associated with NSCL/P. According to Krapels et al who examined maternal nutritional factors related to orofacial cleft in Netherlands, increasing intake of vegetable protein can decrease the risk of orofacial cleft [36].…”

“…Recently, most studies have focused on the identification of risk factors of NSCL/P. Many epidemiological studies have confirmed that maternal age [10–12], maternal educational level [2, 13], family income [13, 14], abnormal reproductive histories [15], family history [14–16], history of infection during pregnancy [17], medication use during pregnancy [18, 19], ambient environment pollution [20], parental occupational hazards exposure [21–23], maternal nutrient intake [23–26], and maternal lifestyle factors (alcohol drinking, smoking) [27–29] are associated with NSCL/P. However, an individual risk prediction tool for NSCL/P has not been reported.…”

Lesiones cariosas reversibles e irreversibles en escolares mexicanos de 11 y 12 años de edad: un análisis de regresión binomial negativa

“…Además, también se acepta la existencia de una asociación entre el estado de salud y el estatus social -en general, los individuos de mejor nivel socioeconómico disfrutan de mejor salud (43,44). En México, la posición socioeconómica, determinada mediante diferentes indicadores, ha demostrado constantemente una asociación con diversos indicadores de salud bucal (45)(46)(47), incluida la caries dental, en la cual se observa que los sujetos de mejor posición socioeconómica tienen menor número y prevalencia de caries dental (38) y viceversa, con pocas excepciones (12). En este estudio se utilizaron diferentes indicadores de posición socioeconómica y el que permaneció en el modelo multivariado fue que el hogar del niño poseía un automóvil.…”

Spatial Clusters of Children with Cleft Lip and Palate and Their Association with Polluted Zones in the Monterrey Metropolitan Area

“…Social exclusion could have some health implications, since groups living in marginalized areas tend to have low educational levels and poor health habits, such as smoking, drinking alcohol, being exposed to contaminants, or not taking vitamin supplements during pregnancy [28,29]. Some sociodemographic factors, such as social exclusion, low economic and educational level, and geographical marginalization have been related to increased incidence of CLP in Mexico [30]. Alfwaress et al reported a similar situation in Jordan: CLP children were born in families with low income and low educational levels [31].…”