IADR Abstract Archives
A Case Control Study of Environmental Factors for Oral Clefts
Objectives: Globally, one infant in every 500-700 newborns is born with an oral cleft. Prior studies suggest low micronutrient status is associated with an increased risk of oral clefts. Environmental factors such as passive smoke exposure or food insecurity, which measures diet quality and hunger, may also affect oral cleft risk. Identifying environmental risk factors for oral clefts can inform on cost-effective, globally relevant, modifiable targets for prevention of oral clefts. Our objective was to examine nutritional and environmental risk factors for oral clefts.
Methods: We conducted a case control study in Northeast Thailand from March 2012 to December 2013. We enrolled 95 cases and 95 controls. We recruited cases with a non-syndromic cleft lip with or without a cleft palate (CL±P) less than 24 months old. Cases were matched to controls on age and place of conception. We collected survey data, a food frequency questionnaire, and measured zinc concentrations in toenail trimmings. We measured food insecurity using a validated 18-item questionnaire. We calculated descriptive statistics by case and control status. We used conditional logistic regression to estimate unadjusted and adjusted associations, 95% confidence intervals (CIs), and p-values.
Results: Any liver intake and the presence of food insecurity in the periconceptional period increased CL±P risk, (adjusted OR (aOR) for more than once per week liver intake versus none: 10.58, 95%CI: 1.74, 64.37, p=0.02; aOR for food insecurity: 9.62, 95% CI: 1.52, 61.05, p=0.02). Passive smoke exposure increased the risk of CL±P (aOR: 6.52, 95% CI: 1.98, 21.44, p<0.01). Too few mothers (n=1) smoked to examine maternal smoking. Toenail zinc concentrations were not associated with CL±P risk.
Conclusions: Our findings add to a growing body of knowledge of environmental risk factors for oral clefts from low and middle-income countries. Large multisite studies are needed to identify environmental and genetic risk factors for oral clefts.
Methods: We conducted a case control study in Northeast Thailand from March 2012 to December 2013. We enrolled 95 cases and 95 controls. We recruited cases with a non-syndromic cleft lip with or without a cleft palate (CL±P) less than 24 months old. Cases were matched to controls on age and place of conception. We collected survey data, a food frequency questionnaire, and measured zinc concentrations in toenail trimmings. We measured food insecurity using a validated 18-item questionnaire. We calculated descriptive statistics by case and control status. We used conditional logistic regression to estimate unadjusted and adjusted associations, 95% confidence intervals (CIs), and p-values.
Results: Any liver intake and the presence of food insecurity in the periconceptional period increased CL±P risk, (adjusted OR (aOR) for more than once per week liver intake versus none: 10.58, 95%CI: 1.74, 64.37, p=0.02; aOR for food insecurity: 9.62, 95% CI: 1.52, 61.05, p=0.02). Passive smoke exposure increased the risk of CL±P (aOR: 6.52, 95% CI: 1.98, 21.44, p<0.01). Too few mothers (n=1) smoked to examine maternal smoking. Toenail zinc concentrations were not associated with CL±P risk.
Conclusions: Our findings add to a growing body of knowledge of environmental risk factors for oral clefts from low and middle-income countries. Large multisite studies are needed to identify environmental and genetic risk factors for oral clefts.