Micronutrients and Oral Clefts

Abstract

Little is known about oral clefts in developing countries. We aimed to identify micronutrientrelated and environmental risk factors for oral clefts in Thailand. We tested hypotheses that maternal exposure during the periconceptional period to multivitamins or liver consumption would decrease cleft lip with or without cleft palate (CL ± P) risk and that menstrual regulation supplements would increase CL ± P risk. We conducted a multisite hospital-based case-control study in Thailand. We enrolled cases with CL ± P and 2 live births as controls at birth from the same hospital. Mothers completed a questionnaire. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Eighty-six cases and 172 controls were enrolled. Mothers who took a vitamin (adjusted OR, 0.39; 95% CI: 0.16, 0.94) or ate liver (adjusted OR, 0.26; 95% CI: 0.12, 0.57) were less likely than those who did not to have an affected child. Mothers who took a menstrual regulation supplement were more likely than mothers who did not to have an affected child. Findings did not differ for infants with a family history of other anomalies or with isolated CL ± P. If replicated, our finding that liver decreases CL ± P risk could offer a lowcost primary prevention strategy.

Case–control study of nutritional and environmental factors and the risk of oral clefts in Thailand

“…Some studies suggest low zinc concentrations may increase oral cleft risk, although associations may vary by place (Krapels et al, ; Tamura et al, ; Munger et al, ). In a recently published study conducted in Thailand, we found that low intake of liver increased oral cleft risk (McKinney et al, ). The only other study to examine liver intake, conducted in Denmark, found no association between liver intake and oral cleft risk but reported that those with the highest levels of vitamin A estimated from liver intake and supplement use combined had a decreased risk of cleft lip with or without cleft palate (CL±P) (Mitchell et al, ).…”

“…Non‐nutritional environmental risk factors are also implicated. For example, in our recently published case–control study in Thailand, we found that menstrual regulation supplements, which may contain alcohol or herbs with estrogenic effects, increase oral cleft risk (McKinney et al, ). Environmental or passive smoke exposure may increase oral cleft risk, but it is difficult to separate out the effects of maternal smoke exposure from other sources of smoke exposure (Li et al, ).…”

Genetic Factors in Selected Complex Congenital Malformations with Cleft Defect

“…A more recent study on the Thai population confirmed the existence of a positive correlation between the intake of multivitamins and the reduced risk of cleft defects. The same effect is observed with meals containing liver, while the intake of menstrual cycle regulators by the mother was associated with an increased risk of offspring born with birth defects [11]. According to some studies, the occurrence of diseases like cold and fever in early pregnancy may also contribute to the formation of cleft anomaly [12].…”

Maternal Intake of Folic Acid Supplementation and Non- syndromic Orofacial Clefts Risk: Systematic Review and Meta Analysis.

“…The relationship between micronutrients and orofacial clefts was examined by C.M. McKinney among the Thai population and women who reported taking a folic acid supplement in the preconception period were 0.51 times as likely to have an affected child than those who did not, although this finding was not statistically significant (P= 0.12) [26]. All included studies characteristics are listed in table 1 .…”