Parental Risk Factors for Oral Clefts among Central Africans, Southeast Asians, and Central Americans
Several lifestyle and en vironmental exposures have beensuspected as risk factors for oral clefts, although few have been convincinglydemonstrated. Studies across global diverse populations could offer additionalinsight given varying types and levels of exposures. Methods: We performed aninternational case–control study in the Democratic Republic of the Congo (133cases, 301 controls), Vietnam (75 cases, 158 controls), the Philippines (102cases, 152 controls), and Honduras (120 cases, 143 controls). Mothers wererecruited from hospitals and their exposures were collected from interviewer-administered questionnaires. We used logistic regression modeling to estimateodds ratios (OR) and 95% confidence intervals (CI). Results: Family history ofclefts was strongly associated with increased risk (maternal: OR 5 4.7; 95% CI,3.0–7.2; paternal: OR 5 10.5; 95% CI, 5.9–18.8; siblings: OR 5 5.3; 95% CI,1.4–19.9). Advanced maternal age (5 year OR 5 1.2; 95% CI, 1.0–1.3),pregestational hypertension (OR 5 2.6; 95% CI, 1.3–5.1), and gestationalseizures (OR 5 2.9; 95% CI, 1.1–7.4) were statistically significant risk factors.Lower maternal (secondary school OR 5 1.6; 95% CI, 1.2–2.2; primary schoolOR 5 2.4, 95% CI, 1.6–2.8) and paternal education (OR 5 1.9; 95% CI, 1.4–2.5; and OR 5 1.8; 95% CI, 1.1–2.9, respectively) and paternal tobaccosmoking (OR 5 1.5, 95% CI, 1.1–1.9) were associated with an increased risk.No other significant associations between maternal and paternal factors werefound; some environmental factors including rural residency, indoor cookingwith wood, chemicals and water source appeared to be associated with anincreased risk in adjusted models. Conclusion: Our study represents one of thefirst international studies investigating risk factors for clefts among multiethnicunderserved populations. Our findings suggest a multifactorial etiology includingboth maternal and paternal factors.
Birth Defects Research Part A: Clinical and Molecular Teratology. doi: 10.1002/bdra.23417, 2015
Jane C. Figueiredo, Stephanie Ly, Kathleen S. Magee, Ugonna Ihenacho, James W. Baurley, Pedro A. Sanchez-Lara, Frederick Brindopke, Thi-Hai-Duc Nguyen, Viet Nguyen, Maria Irene Tangco, Melissa Giron, Tamlin Abrahams, Grace Jang, Annie Vu, Emily Zolfaghari, Caroline A. Yao, Athena Foong, Yves A. DeClerk, Jonathan M. Samet, William Magee III
