Environmental Causes
Posted on March 22nd, 2007
Alcohol and Smoking
Alcohol consumption during early pregnancy may increase risk for cleft lip or palate
[Summary]1
Women who consume higher quantities of alcohol before and during early pregnancy show an increased risk for having babies with orofacial clefts, according to a study published in the March 1999 issue of The Journal of Pediatrics.
Women who consumed five or more drinks at least once a week were about four times more likely to have a baby with a cleft lip or palate than were non-drinkers.
There appeared to be no discernable difference in the risk factor between women who drank less than this amount and non-drinking women.
The study was carried out in California and involved telephone interviews with 731 mothers of babies born with cleft lip or palate and 734 mothers of babies born with no malformation.
Tobacco and alcohol use during pregnancy and risk of oral clefts.
[Abstract]2
OBJECTIVES: This study examined the relationship between maternal tobacco and alcohol consumption during the first trimester of pregnancy and oral clefts.
METHODS: Data were derived from a European multicenter case-control study including 161 infants with oral clefts and 1134 control infants.
RESULTS: Multivariate analyses showed an increased risk of cleft lip with or without cleft palate associated with smoking (odds ratio [OR] = 1.79, 95% confidence interval [CI] = 1.07, 3.04) and an increased risk of cleft palate associated with alcohol consumption (OR = 2.28, 95% CI = 1.02, 5.09). The former risk increased with the number of cigarettes smoked.
CONCLUSIONS: This study provides further evidence of the possible role of prevalent environmental exposures such as tobacco and alcohol in the etiology of oral clefts.
Maternal alcohol use and risk of orofacial cleft birth defects
[Abstract]3
Maternal alcohol use during pregnancy is a known cause of birth defects associated with the fetal alcohol syndrome, but its role in more common, isolated, craniofacial birth defects is not well understood.
A population-based, case-control study of orofacial clefts was conducted in Iowa using births during 1987-1991. Cases were identified by the Iowa Birth Defects Registry and classified as having a cleft lip with or without cleft palate (CLP) or cleft palate only (CP) and whether the cleft was isolated or occurred with other birth defects. Controls were selected from normal Iowa births.
Maternal alcohol use during pregnancy was classified according to self-reported drinks consumed per month. Results are based on 302 controls and the following numbers in each case group: 118 isolated CLP, 56 isolated CP, 51 CLP with multiple defects, and 62 CP with multiple defects.
Compared to women who did not drink alcohol during pregnancy, the relative odds of isolated CLP rose with increasing level of maternal drinking as follows: 1-3 drinks per months, 1.5; 4-10 drinks per month, 3.1; more than 10 drinks per month, 4.7 (chi-square test for trend, P = 0.003). Adjustment for maternal smoking, vitamin use, education, and household income did not substantially alter these results.
RESULT: No significant association was found between alcohol use and isolated cleft palate or clefts in children with multiple birth defects. Alcohol use during pregnancy may be a cause of isolated cleft lip with or without cleft palate.
Significant link found between babies born with cleft lip or palate and mother’s smoking during pregnancy.
Date: March 6, 2000
[Summary]4
According to a study published in Plastic and Reconstructive Surgery [February, 2000], the official medical journal of the American Society of Plastic Surgeons, mothers who smoke during pregnancy run a greater risk of having a baby with cleft lip or palate.
Comparisions were made between 2,207 live births with cleft lips or palates and 4,414 controls without any congenital abnormality. Women who smoked 1 to 10 cigarettes a day saw a risk increase of 50%; smoking between 11 to 20 cigarettes a day increased the risk by 55%; and smoking more than 21 cigarettes a day saw this figure rise to 78%.
The study utilized data from the National Center for Health Statistics 1996 Natality Database of Details on 3,891,494 live births.
Orofacial clefts, parental cigarette smoking, and transforming growth factor-alpha gene variants
[Abstract]5
Results of studies to determine whether women who smoke during early pregnancy are at increased risk of delivering infants with orofacial clefts have been mixed, and recently a gene-environment interaction between maternal smoking, transforming growth factor-alpha (TGFa), and clefting has been reported. Using a large population-based case-control study, we investigated whether parental periconceptional cigarette smoking was associated with an increased risk for having offspring with orofacial clefts. We also investigated the influence of genetic variation of the TGFa locus on the relation between smoking and clefting.
Parental smoking information was obtained from telephone interviews with mothers of 731 (84.7% of eligible) orofacial cleft case infants and with mothers of 734 (78.2%) nonmalformed control infants. DNA was obtained from newborn screening blood spots and genotyped for the allelic variants of TGFa.
We found that risks associated with maternal smoking were most elevated for isolated cleft lip with or without cleft palate, (odds ratio 2.1 [95% confidence interval 1.3-3.6]) and for isolated cleft palate (odds ratio 2.2 [1.1-4.5]) when mothers smoked > or =20 cigarettes/d. Analyses controlling for the potential influence of other variables did not reveal substantially different results. Clefting risks were even greater for infants with the TGFa allele previously associated with clefting whose mothers smoked > or =20 cigarettes/d. These risks for white infants ranged from 3-fold to 11-fold across phenotypic groups.
Paternal smoking was not associated with clefting among the offspring of nonsmoking mothers, and passive smoke exposures were associated with at most slightly increased risks.
This study offers evidence that the risk for orofacial clefting in infants may be influenced by maternal smoke exposures alone as well as in combination (gene-environment interaction) with the presence of the uncommon TGFa allele.
- Original article: Shaw, Gary M., et al. “Maternal Periconceptional Alcohol Consumption and Risk for Orofacial Clefts”. The Journal of Pediatrics, 1999, 134(3), pp.293-303. http://www.ncemch.org/alert/alert051499.htm National Center for Education in Maternal and Child Health, Arlington, Virginia [verified 22 March 2007] [↩]
- C Lorente et al. Tobacco and alcohol use during pregnancy and risk of oral clefts. Occupational Exposure and Congenital Malformation Working Group American Journal of Public Health 2000, 90(3):415-419 [↩]
- Munger RG et al. Maternal alcohol use and risk of orofacial cleft birth defects. Teratology July 1996, 54(1):27-33 [↩]
- Chung, K. C. et al. (2000) Maternal cigarette smoking during pregnancy and the risk of having a child with cleft lip/palate. Plastic and Reconstructive Surgery, February, 105(2):485-91. Abstract available from PubMed at http://www.ncbi.nlm.nih.gov [Do keyword search using title words] [↩]
- Shaw GM et al. Orofacial clefts, parental cigarette smoking, and transforming growth factor-alpha gene variants. American Journal of Human Genetics March 199, 58(3):551-61 [↩]
Comments are closed.
