Reproductive History Factors Associated with Oral Clefts in Puerto Ricans

Objectives: Oral clefts (CL/P) are prevalent birth defects with a multifactorial etiology. Parental factors are studied because it modulates the risk of a child being born with CL/P. The objective of this study is to identify maternal protective and risk factors in the reproductive history that may be associated with CL/P pregnancy outcome.
Methods: Data were collected from a pregnancy history questionnaire conducted in a case-control study (N=420). Mothers with children 0-18 years old with and without non-syndromic CL/P provided information related to maternal preventive and reproductive history that were analyzed using STATA version 14. Chi-square statistical tests and frequencies were calculated for each variable. Crude and adjusted odds ratios (ORs) analysis with confidence intervals at 95% were performed to estimate risk.
Results: Mothers with a mean age of 31.14 years old 8.12 were mostly married (35.4%), with High School degree (35%) and annual income below $10,000 (42.9%). Significant differences were found among cases and controls for income (p=0.02), prior spontaneous abortions (p=0.04), planification of pregnancy (p=0.04), and awareness of pregnancy due to the timing of menstrual periods (p=0.03). Abortions (OR_crude=0.62, 95%CI [0.39,1.01]) were identified as protective factor after adjusting for sociodemographic variables, but those living together (unmarried) were significant (OR_adjusted=0.03, 95%CI [0.00,0.51]). Planning to get pregnant was also identified as protective (OR_crude=0.63, 95%CI [0.39,0.99]), but after adjusting, only those with ≥ $51,000 annual income remained significant (OR_adjusted=0.03, 95%CI [0.001,0.505]), evidencing sociodemographic differences.
Conclusions: There is a limited number of studies of Puerto Rican women concerning the CL/P etiology. Study findings identified preventive behaviors that proved to be protective for CL/P. Differences related to sociodemographic characteristics evidenced a health disparity in this sample of Puerto Ricans. Studies should be conducted in the Caribbean’s multiethnic and culturally diverse populations to compare risk factors and identify preventive behaviors in other Caribbean Nations.