Maternal Cigarette Smoking and Oral Clefts: A Meta-analysis

1997 ◽  
Vol 34 (3) ◽  
pp. 206-210 ◽  
Author(s):  
Diego F. Wyszynski ◽  
David L. Duffy ◽  
Terri H. Beaty
Keyword(s):  
Cigarette Smoking ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Meta Analysis ◽  
First Trimester ◽  
Case Control Studies ◽  
Oral Clefts ◽  
Oral Cleft ◽  
Maternal Cigarette Smoking ◽  
Increased Risk

Objective A meta-analysis was performed to estimate the association between maternal cigarette smoking and the risk of having a child with a nonsyndromic oral cleft (NSOC). Design Studies published from 1966 through 1996 were retrieved using MEDLINE, Current Contents, bibliographies, and other sources. MEDLINE and Current Contents search terms included “oral clefts,” “cigarette smoking,” “birth defects,” and “congenital malformations.” Cohort and case-control studies that enrolled oral cleft patients [cleft lip with or without cleft palate (CL/P), cleft palate (CP), or both] and controls, and presented information on maternal cigarette exposure during pregnancy were included in the analysis. Descriptive and outcome data from each study were independently abstracted by two authors. Results The overall odds ratio of the 11 studies satisfying criteria was 1.29 [95% confidence interval (CI), 1.18 to 1.42] for CL/P and 1.32 (95% CI: 1.10 to 1.62) for CP, Indicating a small increased risk of having a child with either a CL/P or a CP for mothers who smoke during the first trimester of the pregnancy. Conclusions These analyses suggest a small but statistically significant association between maternal cigarette smoking during the first trimester of gestation and increased risk of having a child with a CL/P or CP.

scholarly journals Maternal cigarette smoking before or during pregnancy increases the risk of birth congenital anomalies: a population-based retrospective cohort study of 12 million mother-infant pairs

BMC Medicine ◽  
2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Lili Yang ◽  
Huan Wang ◽  
Liu Yang ◽  
Min Zhao ◽  
Yajun Guo ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Cleft Palate ◽  
Congenital Anomalies ◽  
Maternal Smoking ◽  
Cleft Lip ◽  
First Trimester ◽  
Vital Statistics ◽  
Third Trimester ◽  
Maternal Cigarette Smoking ◽  
Increased Risk

Abstract Background The associations of maternal cigarette smoking with congenital anomalies in offspring have been inconsistent. This study aimed to clarify the associations of the timing and intensity of maternal cigarette smoking with 12 subtypes of birth congenital anomalies based on a nationwide large birth cohort in the USA. Methods We used nationwide birth certificate data from the US National Vital Statistics System during 2016–2019. Women reported the average daily number of cigarettes they consumed 3 months before pregnancy and in each subsequent trimester during pregnancy. Twelve subtypes of congenital anomalies were identified in medical records. Poisson regression analysis was used to estimate the risk ratios (RRs) with 95% confidence intervals (CIs) for 12 subtypes of congenital anomalies associated with the timing (i.e., before pregnancy, and during three different trimesters of pregnancy) and intensity (i.e., number of cigarettes consumed per day) of maternal cigarette smoking. Results Among the 12,144,972 women included, 9.3% smoked before pregnancy and 7.0%, 6.0%, and 5.7% in the first, second, and third trimester, respectively. Maternal smoking before or during pregnancy significantly increased the risk of six subtypes of birth congenital anomalies (i.e., congenital diaphragmatic hernia, gastroschisis, limb reduction defect, cleft lip with or without cleft palate, cleft palate alone, and hypospadias), even as low as 1–5 cigarettes per day. The adjusted RRs (95% CIs) for overall birth congenital anomalies (defined as having any one of the congenital malformations above significantly associated with maternal cigarette smoking) among women who smoked 1–5, 6–10, and ≥ 11 cigarettes per day before pregnancy were 1.31 (1.22–1.41), 1.25 (1.17–1.33), and 1.35 (1.28–1.43), respectively. Corresponding values were 1.23 (1.14–1.33), 1.33 (1.24–1.42), 1.33 (1.23–1.43), respectively, for women who smoked cigarettes in the first trimester; 1.32 (1.21–1.44), 1.36 (1.26–1.47), and 1.38 (1.23–1.54), respectively, for women who smoked cigarettes in the second trimester; and 1.33 (1.22–1.44), 1.35 (1.24–1.47), and 1.35 (1.19–1.52), respectively, for women who smoked cigarettes in the third trimester. Compared with women who kept smoking before and throughout pregnancy, women who never smoked had significantly lower risk of congenital anomalies (RR 0.77, 95% CI 0.73–0.81), but women who smoked before pregnancy and quitted during each trimester of pregnancy had no reduced risk (all P > 0.05). Conclusions Maternal smoking before or during pregnancy increased the risk of several birth congenital anomalies, even as low as 1–5 cigarettes per day. Maternal smokers who stopped smoking in the subsequent trimesters of pregnancy were still at an increased risk of birth congenital anomalies. Our findings highlighted that smoking cessation interventions should be implemented before pregnancy.

Maternal Common Cold or Fever During Pregnancy and the Risk of Orofacial Clefts in the Offspring: A Systematic Review and Meta-analysis

2021 ◽  
pp. 105566562110676
Author(s):  
Fang-ping Shi ◽  
Ying-ying Huang ◽  
Qiao-qun Dai ◽  
Yu-lu Chen ◽  
Hai-yin Jiang ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Common Cold ◽  
Cleft Lip ◽  
Meta Analysis ◽  
Case Control Studies ◽  
Orofacial Clefts ◽  
Random Effects Models ◽  
Relative Risks ◽  
Increased Risk ◽  
The Common

The common cold and/or an associated fever during pregnancy have/has been suspected to harm the developing fetus. We sought possible correlations between a maternal common cold or fever during pregnancy and the risk of orofacial clefts in the offspring. We systematically searched PubMed and Embase using appropriate keywords, and we checked the reference lists of retrieved articles. We used random-effects models to estimate overall relative risks. Incidence of orofacial clefts. We included 13 case-control studies. Modest but statistically significant associations were found between a maternal common cold and cleft lip with or without a cleft palate (CL/CP) (odds ratio [OR] 2.17; 95% confidence interval [CI] 1.66–2.83) and a cleft palate only (CPO) (OR 3.08; 95% CI 1.5–6.34). Furthermore, maternal fever was also associated with an increased risk of CL/CP (OR 1.91, 95% CI 1.3–2.8) and CPO (OR 1.48, 95% CI 0.83–2.63) in the offspring. Further analyses of maternal influenza (alone) yielded similar results. Although evidence of heterogeneity should be carefully evaluated, our findings suggest that maternal common cold or fever during pregnancy may be associated with a greater risk of CL/CP or CPO in the offspring. Future cohort studies using valid assessments of maternal common cold exposure during pregnancy that consider the severity of fever are needed to clarify the contribution of maternal common cold or fever status to the risk of orofacial clefts in children.

Interactions betweenRAD51rs1801321 and maternal cigarette smoking as risk factor for nonsyndromic cleft lip with or without cleft palate

2015 ◽  
Vol 170 (2) ◽  
pp. 536-539 ◽  
Author(s):  
Renato Assis Machado ◽  
Helenara Salvati Bertolossi Moreira ◽  
Sibele Nascimento de Aquino ◽  
Hercilio Martelli-Junior ◽  
Silvia Regina de Almeida Reis ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cigarette Smoking ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Maternal Cigarette Smoking

scholarly journals Efficacy of Periconceptional High-Dose Folic Acid in Isolated Orofacial Cleft Prevention: A Systematic Review

2019 ◽  
Vol 52 (02) ◽  
pp. 153-159 ◽  
Author(s):  
Rajshree Jayarajan ◽  
Anantharajan Natarajan ◽  
Ravindranathan Nagamuttu
Keyword(s):  
Folic Acid ◽  
High Risk ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Meta Analysis ◽  
Strong Association ◽  
Folic Acid Supplementation ◽  
Case Control ◽  
High Dose ◽  
Case Control Studies

Abstract Background The effectiveness of folic acid in prevention of neural tube defects has been well established. Periconceptional supplementation of folic acid in low doses has been shown to be effective in some studies on its efficacy in prevention of occurrence of clefts. There are few studies on high-dose folic acid for prevention of occurrence and recurrence of clefts in high risk cases and the overall consensus based on these is not available. Objectives The aim of this review is to assess whether high-dose folic acid supplementation during the periconceptional period reduces the risk of occurrence of nonsyndromic clefts and recurrence in high-risk cases. Search Methods Search was conducted in the various databases and trial registers. There were no restrictions in the search with regards to language, study setting, or date of publication. Results The search yielded four studies—one randomized control trial, two prospective control trials, and a case–control surveillance on screening 401 articles. The three case–control studies were specifically on recurrence of clefts in high risk cases. The heterogeneity of the studies prevented conduction of a meta-analysis. But results of the studies demonstrate a strong association between high-dose folic acid and isolated nonsyndromic cleft lip with or without cleft palate (CL±CP). But such an effect is weak with regards to isolated cleft palate (CP). Conclusions With the limited evidence available, our conclusion is that high-dose folic acid probably has a role in prevention of recurrence of isolated CL±CP in high-risk individuals, but not CP.

Epidemiology of cleft lip with or without cleft palate in Thais

2017 ◽  
Vol 10 (4) ◽  
pp. 335-338 ◽  
Author(s):  
Rungnapa Ittiwut ◽  
Pichit Siriwan ◽  
Kanya Suphapeetiporn ◽  
Vorasuk Shotelersuk
Keyword(s):  
Family History ◽  
Cleft Palate ◽  
Cleft Lip ◽  
Epidemiological Studies ◽  
Retrospective Case ◽  
Oral Clefts ◽  
Oral Cleft ◽  
History Of ◽  
Maternal Consumption ◽  
Genetic And Environmental Factors

Abstract Background Oral clefts, including cleft lip (CL), CL with cleft palate (CL/CP), and cleft palate only (CPO), are among the most common birth defects, and if left untreated can cause significant morbidity. Causes are complex and involve both genetic and environmental factors. Several studies have demonstrated the highest prevalence of oral clefts being in Asian, white, and African populations. However, there have been very few epidemiological studies of oral clefts in Thais. Objectives To describe the epidemiology and factors associated with oral clefts in Thais. Methods This retrospective case-control observational study included individuals from numerous regions in Thailand. We reviewed data regarding 784 patients with an oral cleft collected in questionnaires as part of the Thai nationwide Smart Smile and Speech Project from 2006 to 2014. Data regarding patients with oral clefts were analyzed, and compared with data regarding 187 unaffected controls. Results Of 784 cases, CL/CP accounted for 59.8%, CPO 21.9%, and CL 18.3%. A family history of oral clefts was detected in all 3 types (P < 0.001). Maternal use of any drugs or herbal medicine not prescribed by physicians during pregnancy in cases of CPO (P = 0.049) and maternal consumption of alcohol during pregnancy in cases of CL/CP (P = 0.047) were significantly higher than that by mothers of controls. Conclusions CL/CP is the most common type of oral cleft. A family history of oral clefts, and maternal consumption of alcohol or nonprescribed drugs are positively associated with oral clefts in Thais.

Maternal Cigarette Smoking and Oral Clefts: A Meta-analysis

1997 ◽  
Vol 34 (3) ◽  
pp. 206-210 ◽  
Author(s):  
Diego F. Wyszynski ◽  
David L. Duffy ◽  
Terri H. Beaty
Keyword(s):  
Cigarette Smoking ◽  
Meta Analysis ◽  
Oral Clefts ◽  
Maternal Cigarette Smoking

scholarly journals Cigarette smoking and the risk of nasopharyngeal carcinoma: a meta-analysis of epidemiological studies

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016582 ◽  
Author(s):  
Mengjuan Long ◽  
Zhenming Fu ◽  
Ping Li ◽  
Zhihua Nie
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cigarette Smoking ◽  
Reference Group ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Undifferentiated Type ◽  
Never Smokers

ObjectiveThe role of cigarette smoking as an independent risk factor for patients with nasopharyngeal carcinoma (NPC) is controversial. We attempted to provide evidence of a reliable association between cigarette smoking and the risk of NPC.DesignMeta-analysis.Data sourcesPubMed online and the Cochrane Library of relevant studies published up to February 2016.Eligibility criteriaAll studies had to evaluate the relationship between NPC and cigarette smoking with never smokers as the reference group.OutcomesThe primary outcome was the adjusted OR, RR or HR of NPC patients comparing smoking with never-smoking; the second was the crude OR, RR or HR.ResultsWe identified 17 case–control studies and 4 cohort studies including 5960 NPC cases and 429 464 subjects. Compared with never smokers, current smokers and ever smokers had a 59% and a 56% greater risk of NPC, respectively. A dose–response relationship was identified in that the risk estimate rose by 15% (p<0.001) with every additional 10 pack-years of smoking, and risk increased with intensity of cigarette smoking (>30 cigarettes per day). Significantly increased risk was only found among male smokers (OR, 1.36; 95% CI 1.15 to 1.60), not among female smokers (OR, 1.58; 95% CI 0.99 to 2.53). Significantly increased risk also existed in the differentiated (OR, 2.34; 95% CI 1.77 to 3.09) and the undifferentiated type of NPC (OR, 1.15; 95% CI 0.90 to 1.46). Moreover, people who started smoking at younger age (<18 years) had a greater risk than those starting later for developing NPC (OR, 1.78; 95% CI 1.41 to 2.25).ConclusionsCigarette smoking was associated with increased risk of NPC, especially for young smokers. However, we did not find statistical significant risks of NPC in women and in undifferentiated type, which might warrant further researches.

scholarly journals Trends in Enteral Access Placement Among Patients With Oral Clefts: Evaluation of 46 617 Patient Admissions

2018 ◽  
Vol 56 (1) ◽  
pp. 21-30
Author(s):  
Thanapoom Boonipat ◽  
Nicholas S. Adams ◽  
Allen L. Shoemaker ◽  
Robert J. Mann ◽  
John W. Polley ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Enteral Feeding ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Complication Rates ◽  
Oral Clefts ◽  
Patient Admissions ◽  
Increased Risk ◽  
Enteral Access ◽  
Isolated Cleft Palate

Objective: It is well known that patients with oral clefts have challenges with feeding. Enteral feeding access, in the form of gastrostomy, is often utilized to supplement or replace oral intake. Although commonly performed, these procedures have reported complication rates as high as 83%. We intend to discover rates of enteral access in patients with oral clefts and report-related outcomes. Design: The Healthcare Cost Utilization Project Kids’ Inpatient Database from 2000 to 2012 was analyzed using patients with oral clefts and enteral access procedures. The χ2 test was used for univariate analyses of proportions, and linear regression was used to analyze trends. Multivariate logistic regression was used to analyze odds ratios. Results: Of the 46 617 patient admissions included, 14.6% had isolated cleft lip (CL), 51.7% cleft lip and palate (CLP), and 43.7% isolated cleft palate. The rates of enteral access in the oral cleft population increased from 3.7% in 2000 to 5.8% in 2012 ( P < .001). Increased rates were identified in patients with ( P = .019) and without ( P < .001) complex conditions. A significant increase in the rate of enteral access was seen in patients with CLP ( P < .001) and isolated cleft palate ( P < .001). No difference was seen in the isolated CL group ( P = .096). Patients with complex conditions were at a 4.4-fold increased risk and those admitted to urban, teaching hospitals were at a 4.7-fold risk of enteral access placement. Conclusions: The rates for enteral feeding access increased significantly from 2000 to 2012. The reasons for the increased incidence are unclear. Invasive enteral access procedures have been shown to have a multitude of complications. Careful patient selection should be done before placement of invasive enteral access.

scholarly journals Oral Clefts and Academic Performance in Adolescence: The Impact of Anesthesia-Related Neurotoxicity, Timing of Surgery, and Type of Oral Clefts

2017 ◽  
Vol 54 (4) ◽  
pp. 371-380 ◽  
Author(s):  
Nicola G. Clausen ◽  
Dorthe A. Pedersen ◽  
Jacob K. Pedersen ◽  
Susanne E. Møller ◽  
Dorthe Grosen ◽  
...  
Keyword(s):  
Academic Performance ◽  
Cleft Palate ◽  
Birth Cohort ◽  
Cleft Lip ◽  
Ninth Grade ◽  
Mean Difference ◽  
Control Group ◽  
Oral Clefts ◽  
Oral Cleft ◽  
The Impact

Objective Early life exposure to anesthesia and surgery is suspected to associate with cognitive impairment later in life. We compared academic achievement among adolescents with cleft lip only (CL), cleft palate only (CP), and cleft lip and cleft palate (CLP) with a noncleft control group to investigate whether outcome depends on timing and number of operations during childhood and/or type of oral cleft. Design Nationwide register-based follow-up study. Setting Danish birth cohort 1986 to 1990. Participants Five hundred fifty-eight children with isolated CL (n = 171), CLP (n =222), or CP (n = 195), of which 509 children had been exposed to anesthesia and one or more cleft operation(s), and a 5% sample of the birth cohort (n = 14,677). Main Outcome Measure(s) Test score in the Danish standardized ninth-grade exam and proportion of nonattainment, defined as “results for ninth-grade exam unavailable.” Data adjusted for sex, birth weight, parental age, and parental level of education. Results Compared to controls, children with CL achieved higher scores (mean difference 0.12, 95% CI –0.05; 0.29) and children with CLP presented with lower scores (mean difference –0.06, 95% CI –0.21; 0.09), albeit both statistically insignificant. Children with CP achieved significantly lower scores, mean difference –0.20 (95% CI –0.38; –0.03). Odds ratios for nonattainment at final exam were: CL 0.79 (95% CI 0.46; 1.35), CLP 1.07 (95% CI 0.71; 1.61), CP 2.59 (95% CI 1.78; 3.76). Conclusions Oral cleft type rather than number and timing of anesthesia and operations associate to poorer academic performance. Although a potential neurotoxic effect due to anesthetic agents is not reflected in the data, it cannot be completely excluded.

scholarly journals Association of the WNT3 polymorphisms and non-syndromic cleft lip with or without cleft palate: evidence from a meta-analysis

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Bing-qian Wang ◽  
Shu-tao Gao ◽  
Kun Chen ◽  
Zhu-qiu Xu ◽  
Jia-ming Sun ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Case Control Studies ◽  
Online Databases ◽  
Language Restriction ◽  
Newcastle Ottawa Scale ◽  
Allele Model ◽  
Ottawa Scale

Objective: This meta-analysis was conducted with the aim of investigating the association between WNT3 gene polymorphisms and non-syndromic cleft lip (CL) with or without cleft palate (NSCL/P) predisposition. Methods: A comprehensive literature search was performed in six online databases including PubMed, Embase, ISI Web of Science, CENTRAL, CNKI, and Wanfang from inception up to June 2018 without language restriction. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (95%CIs) were calculated under allele model of inheritance to indicate the association between WNT3 polymorphisms and NSCL/P. Risk of bias was assessed through the Newcastle–Ottawa scale (NOS). Predetermined stratified and sensitivity analyses were performed using the RevMan 5.3 software, publication bias were evaluated by Egger’s and Begg’s tests. Results: Seven case–control studies comprising 1617 NSCL/P patients and 2143 healthy controls were identified and included in the present study, a total of eight loci were investigated in the present study: rs3809857 was significantly associated with NSCL/P vulnerability (G compared with T, OR = 1.34, 95%CI: 1.15–1.56, P=0.0001), a significant association between rs9890413 polymorphism and NSCL/P susceptibility (A compared with G, OR = 1.25, 95%CI: 1.06–1.47, P=0.007) was detected as well. Since only few studies reported detailed data about the association between rs142167, rs7207916, rs199498, rs111769, rs12452064, rs11653738, and NSCL/P risk, these results were not combined using meta-analysis. Conclusion: Based on the findings of our current study, the rs3809857 and rs9890413 polymorphisms of WNT3 appeared to be associated with NSCL/P. Limited evidence is found to support the association between other WNT3 polymorphisms and risk of NSCL/P.

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