Oral clefts and life style factors — A case-cohort study based on prospective Danish data

Abstract

This study examines the association between oral clefts and first trimester maternal lifestyle factors based on prospective data from the Danish National Birth Cohort. The cohort includes approximately 100,000 pregnancies. In total 192 mothers gave birth to child with an oral cleft during 1997-2003. Information on risk factors such as smoking, alcohol consumption, tea, coffee, cola, and food supplements was obtained during pregnancy for these and 828 randomly selected controls. We found that first trimester maternal smoking was associated with an increased risk of oral clefts (odds ratio (OR): 1.50; 95% confidence interval (CIs): 1.05, 2.14). Although not statistically significant, we also saw associations with first trimester consumption of alcohol (OR: 1.11; CIs: 0.79, 1.55), tea (OR: 1.31; CIs: 0.93, 1.86), and drinking more than 1 l of cola per week (OR: 1.40; CIs: 0.92, 2.12). Furthermore supplementation with > or =400 mcg folic acid daily during the entire first trimester (OR: 0.75; CIs: 0.46, 1.22) suggested an inverse associated with oral clefts, similar to our results on coffee drinking. No effects were found for smaller doses of folic acid, vitamin A, B6 or B12 in this study. The present study found an association between oral clefts and smoking and, although not conclusive, supports an association of oral cleft with alcohol.

Review on genetic variants and maternal smoking in the etiology of oral clefts and other birth defects

“…Studying data collected from National Birth Defect Prevention Study, Honein et al (2007) reported an odds ratio (OR) of 1.3 (95% CI: 1.0-1.6) for CL/P, an even stronger association with bilateral CL/P (OR = 1.7; 95% CI: 1.2-2.6), and a weaker association for CPO. An OR of 1.50 (95% CI: 1.05-2.14) for CL/P was reported in a Danish study (Bille et al, 2007). Despite the positive association identified between maternal smoking and clefting in Denmark, the decrease in smoking prevalence among pregnant women in the last 20 years in Denmark did not seem to reduce the rate of cleft prevalence as suggested by the similar occurrence of clefts in 1988-2001 to the occurrence in 1962-1987(Bille et al, 2005.…”

Corticosteroid use during pregnancy and risk of orofacial clefts

“…These confounders were selected using previously described associations with clefts found in the literature. [14][15][16][17][18][19][20][21][22][23] Information on maternal age at the start of pregnancy, parity and smoking status during pregnancy was obtained from the Danish Medical Birth Registry; the mother's place of origin and her place of residence at the start of pregnancy were obtained from the Danish Central Person Register, which contains complete and continually updated demographic information on all Danish residents; 24 the level of education and socioeconomic status of the mother during the year in which pregnancy started was obtained from Statistics Denmark.…”

The I105V polymorphism in glutathione S-transferase P1, parental smoking and the risk for nonsyndromic cleft lip with or without cleft palate

“…Their development was affected, however, when exposed to toxicants only. 26 The aims of this study were (1) to investigate the GSTP1 I105V polymorphism in case and control triads in a Dutch population (mother, father, child) and (2) to evaluate the interactions between this polymorphism and periconception parental smoking and orofacial cleft risk.…”