Population Attributable Fractions of Modifiable Risk Factors for Nonsyndromic Orofacial Clefts: A Prospective Cohort Study From the Japan Environment and Children’s Study

Sato, Yukihiro; Yoshioka, Eiji; Saijo, Yasuaki; Miyamoto, Toshinobu; Sengoku, Kazuo; Azuma, Hiroshi; Tanahashi, Yusuke; Ito, Yoshiya; Kobayashi, Sumitaka; Minatoya, Machiko; Bamai, Yu Ait; Yamazaki, Keiko; Itoh, Shinji; Miyashita, Chihiro; Ikeda‐Araki, Atsuko; Kishi, Reiko

doi:10.2188/jea.je20190347

Cited by 17 publications

(15 citation statements)

References 43 publications

(73 reference statements)

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“…This high volume of research should have provided a clear indication of the association between maternal smoking and CL/P, but the poor quality of studies overall has compromised the reliability of the reported findings. Only three studies out of the 45 included in this review were judged to be of good quality (Grewal et al, 2008;Raut et al, 2019;Sato et al, 2020;). The most common reason for poor quality within the studies was a failure to adjust for recognized confounding factors, placing the analyses at high risk of bias.…”

Section: Summary Of Evidencementioning

confidence: 99%

Maternal cigarette smoking and cleft lip and palate: A systematic review and meta-analysis

Fell

Dack

Chummun

et al. 2021

Preprint

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Objectives: A systematic review and meta-analysis to determine the association between active maternal smoking and cleft lip and palate etiology. Data Sources: Medline, Embase, Web of Science and the Cochrane database from inception to November 2020. Study selection: Observational studies of cigarette smoking habits in pregnant women. Outcomes included cleft lip and/or palate, cleft lip +- palate and cleft palate only. Data analysis: Publication bias analyses were performed and the Newcastle Ottawa scales were used to assess study quality. Fixed or random effect models were used in the meta-analysis, dependent on risk of statistical heterogeneity. Results: Forty-five studies were eligible for inclusion of which 11 were cohort and 34 were case-control studies. Sixteen studies were of sufficient standard for inclusion in the meta-analysis. The summary odds ratio for the association between smoking and cleft lip and/or palate was 1.42 (95%CI 1.27 to 1.59) with a population attributable fraction of 4% (95%CI 3% - 5%). There was limited evidence to show a dose-response effect of smoking. Conclusions: This review reports a moderate association between maternal smoking and orofacial cleft but the overall quality of the conventional observational studies included was poor. There is a need for high quality and novel research strategies to further define the role of smoking in the etiology of cleft lip and palate.

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Section: Summary Of Evidencementioning

confidence: 99%

Maternal cigarette smoking and cleft lip and palate: A systematic review and meta-analysis

Fell

Dack

Chummun

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…This high volume of research should have provided a clear indication of the association between maternal smoking and CL/P, but the poor quality of studies overall has compromised the validity of the reported findings. Only three studies out of the 45 included in this review were judged to be of good quality (Grewal et al, 2008; Raut et al, 2019; Sato et al, 2020). The most common reason for poor quality within the studies was a failure to adjust for recognized confounding factors, placing the analyses at high risk of bias.…”

Section: Discussionmentioning

confidence: 99%

Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis

Fell

Dack

Chummun

et al. 2021

The Cleft Palate Craniofacial Journal

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A systematic review and meta-analysis to determine the association between active maternal smoking and cleft lip and palate etiology. Medline, Embase, Web of Science and the Cochrane Library from inception to November, 2020. Observational studies of cigarette smoking habits in pregnant women. Outcomes included cleft lip and/or palate, cleft lip ± palate and cleft palate only. Publication bias analyses were performed and the Newcastle Ottawa scales were used to assess study quality. Fixed or random effect models were used in the meta-analysis, dependent on risk of statistical heterogeneity. Forty-five studies were eligible for inclusion of which 11 were cohort and 34 were case–control studies. Sixteen studies were of sufficient standard for inclusion in the meta-analysis. The summary odds ratio for the association between smoking and cleft lip and/or palate was 1.42 (95%CI 1.27-1.59) with a population attributable fraction of 4% (95%CI 3%-5%). There was limited evidence to show a dose–response effect of smoking. This review reports a moderate association between maternal smoking and orofacial cleft but the overall quality of the conventional observational studies included was poor. There is a need for high quality and novel research strategies to further define the role of smoking in the etiology of cleft lip and palate.

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“…A recent study in Brazil found elevated but nonsignificant risk associated with alcohol consumption at the highest frequency measured (OR = 1.55, 95% CI: 0.56, 4.26). Another recent study in Japan also observed no relationship between maternal drinking and OFC by two metrics: the mother quit drinking after pregnancy (OR = 0.87, 95% CI 0.63, 1.22) versus current drinker during pregnancy (OR = 0.71, 95% CI: 0.22, 2.27; Sato et al, 2020). Meta‐analysis by Yin et al similarly found no relationship between any drinking and CL/P (OR = 1.00, 95% CI: 0.87, 1.15) or CPO (OR = 1.02, 95% CI: 0.92, 1.14; Yin et al, 2019).…”

Section: Behavioral Risk Factors For Ofcsmentioning

confidence: 92%

“…Honein et al found that up to 6.1% of OFC cases in the United States could be prevented by ceasing maternal active smoking in the periconceptual period of pregnancy (Honein et al, 2014). A recent prospective case–control study on a Japanese population indicated that the PAF of CL/P due to maternal active smoking is 9.9%, and 10.8% for passive smoking (Sato et al, 2020).…”

Section: Behavioral Risk Factors For Ofcsmentioning

confidence: 99%

Environmental mechanisms of orofacial clefts

Garland

Reynolds

Zhou

2020

Birth Defects Research

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Orofacial clefts (OFCs) are among the most common birth defects and impart a significant burden on afflicted individuals and their families. It is increasingly understood that many nonsyndromic OFCs are a consequence of extrinsic factors, genetic susceptibilities, and interactions of the two. Therefore, understanding the environmental mechanisms of OFCs is important in the prevention of future cases. This review examines the molecular mechanisms associated with environmental factors that either protect against or increase the risk of OFCs. We focus on essential metabolic pathways, environmental signaling mechanisms, detoxification pathways, behavioral risk factors, and biological hazards that may disrupt orofacial development.

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Population Attributable Fractions of Modifiable Risk Factors for Nonsyndromic Orofacial Clefts: A Prospective Cohort Study From the Japan Environment and Children’s Study

Abstract: This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process which may lead to differences between this version and the Version of Record.

Cited by 17 publications

References 43 publications

Maternal cigarette smoking and cleft lip and palate: A systematic review and meta-analysis

Maternal cigarette smoking and cleft lip and palate: A systematic review and meta-analysis

Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis

Environmental mechanisms of orofacial clefts

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