Folic acid supplements and risk of facial clefts: national population based case-control study

Wilcox, Allen J.; Lie, Rolv Terje; Solvoll, Kari; Taylor, Jack A.; McConnaughey, D. Robert; Åbyholm, Frank; Vindenes, Hallvard; Vollset, Stein Emil; Drevon, Christian A.

doi:10.1136/bmj.39079.618287.0b

Cited by 360 publications

(271 citation statements)

References 17 publications

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“…Especially from an anthropological viewpoint, the phylogenetic rise in the frequency of malocclusions correlates with fewer masticatory demands on human dentition, which in turn is also associated with the consumption of softer foods [14,93]. During ontogenesis, results of more recent studies suggest that the organism's supply of nutrients, especially vitamins, during early pregnancy influences the occurrence of cleft formation in infants [36,96] and that an early supplement of folic acid can have a protective effect [7,58,100].…”

Section: Introductionmentioning

confidence: 99%

Malocclusion, Mastication and the Gastrointestinal System

Proff

2010

J Orofac Orthop

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The relationship between malocclusion and the gastrointestinal system has only been examined occasionally, while several pertinent studies have addressed the chewing function as a functional link between oral structures and the gastrointestinal tract. Following an overview of the physiological masticatory process, the available evidence regarding associations among dental status, chewing function and gastrointestinal disorders are summarized. Finally, a review of the relationships between orthodontic deformities and mastication is presented.

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Section: Introductionmentioning

confidence: 99%

Malocclusion, Mastication and the Gastrointestinal System

Proff

2010

J Orofac Orthop

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“…A population-based study conducted in Norway, which has one of the highest rates of facial clefts in Europe, estimated that 22 percent of isolated cleft palate cases in Norway could be averted if all pregnant women took 0.4 mg of folic acid per day. This was supported by research at the National Institute of Environmental Health Sciences (NIEHS) in the USA, part of the National Institutes of Health, who found that 0.4mg a day of folic acid reduced a babies risk of isolated cleft lip by one third [19]. The occurrence of cleft palate in our cohort was in an unplanned pregnancy and therefore it is plausible that increased folic acid prior to conception could have reduced the risk.…”

Section: Discussionmentioning

confidence: 85%

Managing Successful Pregnancies in Patients with Chronic Intestinal Failure on Home Parenteral Nutrition: Experience from a UK National Intestinal Failure Unit

Bond

Vasant

Gashau

et al. 2017

JGLD

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Background & Aim: There are minimal reports of pregnancy in the chronic intestinal failure (CIF)/ home parenteral nutrition (HPN) population, with some concern relating to the risk associated with such pregnancies. The aim of this retrospective observational study was to evaluate pregnancy experience and outcomes in patients with CIF requiring HPN in a national UK CIF referral centre.Method: All known pregnancies in patients treated with HPN for CIF between 1982 and 2016 were identified retrospectively from a prospectively maintained database. Maternal and foetal outcomes were collated, along with PN requirements before and during pregnancy.Results: There were 5 pregnancies in 5 mothers in our cohort consisting of over 700 patients, males and females. The median age at conception was 28 years (range 24-33 years). The median duration on HPN prior to pregnancy was 26 months (range 4-85 months). One patient had Crohn’s disease, another had pan-enteric dysmotility and the other three patients had ischaemic complications leading to short bowel syndrome (SBS). All mothers were intensively monitored in an obstetric clinic and a dedicated CIF multi-disciplinary clinic throughout pregnancy. There were 2/5 preterm deliveries. One of the preterm deliveries was associated with spontaneous labour and the other had a planned induction as a result of maternal clinical need. Neonatal complications were seen in both prenates. There were no recorded maternal catheter related line infections during the 5 pregnancies.Conclusion: Successful pregnancy whilst receiving HPN is feasible but requires close, intensive monitoring and dedicated optimisation of PN in order to minimise maternal and foetal complications. All women of child-bearing age on HPN should be counselled about pregnancy.Abbreviations: ALP: alkaline phosphatase; ALT: alanine transaminase; CIF: chronic intestinal failure; HPN: home parenteral nutrition; IBD: inflammatory bowel disease; IF: intestinal failure; IFALD: Intestinal Failure associated liver disease; LFT: liver function test; PN: parenteral nutrition; RDA: Recommended daily allowance; SBS: short bowel syndrome; TPN: total parenteral nutrition.

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“…Another explanation for the association between maternal obesity and congenital malformation is that maternal obesity is associated with nutritional deficiencies especially reduced folate levels [39]. There is evidence to show that low folate levels in pregnant women increases the risk of orofacial clefts in their offspring [40][41][42][43]. Different epidemiological studies have been done to investigate the relationship between obesity and orofacial clefts.…”

Section: Introductionmentioning

confidence: 99%

What is the Risk of Having Offspring with Cleft Lip/Palate in Pre-Maternal Obese/Overweight Women When Compared to Pre-Maternal Normal Weight Women? A Systematic Review and Meta-Analysis

Izedonmwen¹,

Cunningham²,

Macfarlane

2015

JOMR

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Objectives: The purpose of the study was to identify the risk of orofacial cleft in the offspring of women with pre-maternal obesity/overweight when compared with pre-maternal normal weight women. Material and Methods: MEDLINE and EMBASE were searched from 1980 to July 2014 for cohort, case control and cross sectional studies. BMI were categorized according to WHO recommendation: normal weight (BMI 18.5 -24.9), overweight (BMI 25 -29.9) and obese (BMI ≥ 30). Results: Six studies were identified; three case control studies which were used for the meta-analysis and two cross sectional studies and one cohort study. Compared with women of recommended BMI, obese women were at increased odds of pregnancy affected by CLP (OR = 1.16; 95% CI 1, 1.34) and CP (OR = 1.14; 95% CI 0.95, 1.37). Overweight women were also at increased odds of pregnancy affected by CLP (OR = 1.06; 95% CI 0.93, 1.21) but not CP (OR = 0.89; 95% CI 0.75, 1.06). The results of the risk ratios reported in the cross sectional and cohort studies were similar to the results of the meta-analysis. Conclusions:The results of this study reveal that there is an increased risk of having offspring with orofacial cleft in obese/ overweight women. The reason for this association is not known. Although, the risk is small, it is important because of the increasing incidence of obesity.

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Folic acid supplements and risk of facial clefts: national population based case-control study

Cited by 360 publications

References 17 publications

Malocclusion, Mastication and the Gastrointestinal System

Malocclusion, Mastication and the Gastrointestinal System

Managing Successful Pregnancies in Patients with Chronic Intestinal Failure on Home Parenteral Nutrition: Experience from a UK National Intestinal Failure Unit

What is the Risk of Having Offspring with Cleft Lip/Palate in Pre-Maternal Obese/Overweight Women When Compared to Pre-Maternal Normal Weight Women? A Systematic Review and Meta-Analysis

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