Document Detail

Maternal smoking and environmental tobacco smoke exposure and the risk of orofacial clefts.
MedLine Citation:
PMID:  17202867     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Smoking during pregnancy has been associated with orofacial clefts in numerous studies. However, most previous studies have not been able to assess the relation between maternal smoking and specific phenotypes (eg, bilateral clefts). METHODS: We examined the association between periconceptional maternal smoking, environmental tobacco smoke (ETS) exposure, and cleft lip with or without cleft palate (CLP) (n = 933) and cleft palate only (CPO) (n = 528) compared with infants with no major birth defects (n = 3390). Infants were born between 1 October 1997 and 31 December 2001, and exposures were ascertained from maternal telephone interviews for the National Birth Defects Prevention Study. We excluded infants who had a first-degree relative with an orofacial cleft. Effect estimates were adjusted for folic acid use, study site, prepregnancy obesity, alcohol use, gravidity, and maternal age, education, and race/ethnicity. RESULTS: Periconceptional smoking was associated with CLP (odds ratio = 1.3; 95% confidence interval = 1.0-1.6), and more strongly associated with bilateral CLP (1.7; 1.2-2.6), with a weaker association observed for CPO. Heavy maternal smoking (25+ cigarettes/day) was associated with CLP (1.8; 1.0-3.2), bilateral CLP (4.2; 1.7-10.3), and CPO with Pierre Robin sequence (2.5; 0.9-7.0). ETS exposure was not associated with CLP or CPO. CONCLUSIONS: This study confirmed the modest association between smoking and orofacial clefts that has been consistently reported, and identified specific phenotypes most strongly affected.
Margaret A Honein; Sonja A Rasmussen; Jennita Reefhuis; Paul A Romitti; Edward J Lammer; Lixian Sun; Adolfo Correa
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Epidemiology (Cambridge, Mass.)     Volume:  18     ISSN:  1044-3983     ISO Abbreviation:  Epidemiology     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-15     Completed Date:  2007-03-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9009644     Medline TA:  Epidemiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  226-33     Citation Subset:  IM    
National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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MeSH Terms
Case-Control Studies
Cleft Lip / epidemiology*,  etiology
Cleft Palate / epidemiology*,  etiology
Infant, Newborn
Middle Aged
Odds Ratio
Pierre Robin Syndrome / epidemiology*,  etiology
Prenatal Exposure Delayed Effects / epidemiology*
Smoking / adverse effects*
Tobacco Smoke Pollution / adverse effects*
United States / epidemiology
Reg. No./Substance:
0/Tobacco Smoke Pollution

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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