Maternal Cigarette Smoking during Pregnancy and Risk of Oral Clefts in Newborns
The results of previous epidemiologic research on the possible association between maternal smoking during pregnancy and risk of oral clefts in offspring have been inconsistent. This may be due in part to methodological limitations, including imprecise measurement of tobacco use, failure to consider...
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| Veröffentlicht in: | American journal of epidemiology 1999-10, Vol.150 (7), p.683-694 |
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| creator | Lieff, Susan Olshan, Andrew F. Werler, Matha Strauss, Ronald P. Smith, Jonna Mitchell, Allen |
| description | The results of previous epidemiologic research on the possible association between maternal smoking during pregnancy and risk of oral clefts in offspring have been inconsistent. This may be due in part to methodological limitations, including imprecise measurement of tobacco use, failure to consider etiologic heterogeneity among types of oral clefts, and confounding. This analysis, based on a large case-control study, further evaluated the effect of first trimester maternal smoking on oral facial cleft risk by examining the dose-response relationship according to specific cleft type and according to whether or not additional malformations were present. A number of factors, including dietary and supplemental folate intake and family history of clefts, were evaluated as potential confounders and effect modifiers. Data on 3, 774 mothers interviewed between 1976 and 1992 by the Slone Epidemiology Unit Birth Defects Study were used. Study subjects were actively ascertained from sites in areas around Boston, Massachusetts and Philadelphia, Pennsylvania; the state of Iowa; and southeastern Ontario, Canada. Cases were infants with isolated defects—cleft lip alone (n = 334), cleft lip and palate (n = 494), or cleft palate alone (n = 244)—and infants with clefts plus (+) additional malformations: cleft lip+ (n = 58), cleft lip and palate+ (n = 140), or cleft palate+ (n = 209). Controls were infants with defects other than clefts, excluding defects possibly associated with maternal cigarette use. There were no associations with maternal smoking for any oral cleft group, except for a positive dose response among infants with cleft lip and palate+ (for light smokers, odds ratio (OR) = 1.09 (95% confidence interval (Cl): 0.6, 1.9); for moderate smokers, OR = 1.84 (95% Cl: 1.2, 2.9); and for heavy smokers, OR = 1.85 (95% Cl: 1.0, 3.5), relative to nonsmokers). This finding may be related to the additional malformations rather than to the cleft itself. Am J Epidemiol 1999; 150: 683-94. |
| doi_str_mv | 10.1093/oxfordjournals.aje.a010071 |
| format | Article |
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This may be due in part to methodological limitations, including imprecise measurement of tobacco use, failure to consider etiologic heterogeneity among types of oral clefts, and confounding. This analysis, based on a large case-control study, further evaluated the effect of first trimester maternal smoking on oral facial cleft risk by examining the dose-response relationship according to specific cleft type and according to whether or not additional malformations were present. A number of factors, including dietary and supplemental folate intake and family history of clefts, were evaluated as potential confounders and effect modifiers. Data on 3, 774 mothers interviewed between 1976 and 1992 by the Slone Epidemiology Unit Birth Defects Study were used. Study subjects were actively ascertained from sites in areas around Boston, Massachusetts and Philadelphia, Pennsylvania; the state of Iowa; and southeastern Ontario, Canada. Cases were infants with isolated defects—cleft lip alone (n = 334), cleft lip and palate (n = 494), or cleft palate alone (n = 244)—and infants with clefts plus (+) additional malformations: cleft lip+ (n = 58), cleft lip and palate+ (n = 140), or cleft palate+ (n = 209). Controls were infants with defects other than clefts, excluding defects possibly associated with maternal cigarette use. There were no associations with maternal smoking for any oral cleft group, except for a positive dose response among infants with cleft lip and palate+ (for light smokers, odds ratio (OR) = 1.09 (95% confidence interval (Cl): 0.6, 1.9); for moderate smokers, OR = 1.84 (95% Cl: 1.2, 2.9); and for heavy smokers, OR = 1.85 (95% Cl: 1.0, 3.5), relative to nonsmokers). This finding may be related to the additional malformations rather than to the cleft itself. Am J Epidemiol 1999; 150: 683-94.</description><identifier>ISSN: 0002-9262</identifier><identifier>EISSN: 1476-6256</identifier><identifier>DOI: 10.1093/oxfordjournals.aje.a010071</identifier><identifier>PMID: 10512422</identifier><identifier>CODEN: AJEPAS</identifier><language>eng</language><publisher>Cary, NC: Oxford University Press</publisher><subject>abnormalities ; Abnormalities, Multiple - epidemiology ; Adult ; Biological and medical sciences ; Boston - epidemiology ; Case-Control Studies ; cleft lip ; Cleft Lip - epidemiology ; Cleft lip/palate ; cleft palate ; Cleft Palate - epidemiology ; Confidence Intervals ; Confounding Factors (Epidemiology) ; Diseases of mother, fetus and pregnancy ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Infant, Newborn ; intrauterine exposure ; Iowa - epidemiology ; Male ; Medical sciences ; multiple ; Odds Ratio ; Ontario - epidemiology ; Philadelphia - epidemiology ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy. Fetus. 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This may be due in part to methodological limitations, including imprecise measurement of tobacco use, failure to consider etiologic heterogeneity among types of oral clefts, and confounding. This analysis, based on a large case-control study, further evaluated the effect of first trimester maternal smoking on oral facial cleft risk by examining the dose-response relationship according to specific cleft type and according to whether or not additional malformations were present. A number of factors, including dietary and supplemental folate intake and family history of clefts, were evaluated as potential confounders and effect modifiers. Data on 3, 774 mothers interviewed between 1976 and 1992 by the Slone Epidemiology Unit Birth Defects Study were used. Study subjects were actively ascertained from sites in areas around Boston, Massachusetts and Philadelphia, Pennsylvania; the state of Iowa; and southeastern Ontario, Canada. Cases were infants with isolated defects—cleft lip alone (n = 334), cleft lip and palate (n = 494), or cleft palate alone (n = 244)—and infants with clefts plus (+) additional malformations: cleft lip+ (n = 58), cleft lip and palate+ (n = 140), or cleft palate+ (n = 209). Controls were infants with defects other than clefts, excluding defects possibly associated with maternal cigarette use. There were no associations with maternal smoking for any oral cleft group, except for a positive dose response among infants with cleft lip and palate+ (for light smokers, odds ratio (OR) = 1.09 (95% confidence interval (Cl): 0.6, 1.9); for moderate smokers, OR = 1.84 (95% Cl: 1.2, 2.9); and for heavy smokers, OR = 1.85 (95% Cl: 1.0, 3.5), relative to nonsmokers). This finding may be related to the additional malformations rather than to the cleft itself. Am J Epidemiol 1999; 150: 683-94.</description><subject>abnormalities</subject><subject>Abnormalities, Multiple - epidemiology</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Boston - epidemiology</subject><subject>Case-Control Studies</subject><subject>cleft lip</subject><subject>Cleft Lip - epidemiology</subject><subject>Cleft lip/palate</subject><subject>cleft palate</subject><subject>Cleft Palate - epidemiology</subject><subject>Confidence Intervals</subject><subject>Confounding Factors (Epidemiology)</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>intrauterine exposure</subject><subject>Iowa - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>multiple</subject><subject>Odds Ratio</subject><subject>Ontario - epidemiology</subject><subject>Philadelphia - epidemiology</subject><subject>Pregnancy</subject><subject>Pregnancy Trimester, First</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Risk Factors</subject><subject>Sex Distribution</subject><subject>smoking</subject><subject>Smoking - epidemiology</subject><issn>0002-9262</issn><issn>1476-6256</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtvEzEURi0EomnhLyALIXYTrt8xO4goRWoJoiCqbCyPH9Ekk3GxZ9T23zOjRDxWSJbuwue7j4PQSwJzApq9SfcxZb9NQ-5sW-Z2G-YWCIAij9CMcCUrSYV8jGYAQCtNJT1Bp6VsAQjRAp6iEwKCUE7pDK2ubB-mPnjZbGwOfR_w9T7tmm6D_ZCn8iWHTWc794Bt5_HXpuxwiniVp0wbYl9w0-HP4a5OuSvP0JM4LhWeH-sZ-n7-4dvyorpcffy0fHdZOS5FX8nFgmuthYtOaer5IoINxAcNHoisg5WqVsIxXVvOvANbK665Z4pYEmTk7Ay9PvS9zennEEpv9k1xoW1tF9JQjIIF5Vqw_4JEcWCCqhF8ewBdTqXkEM1tbvY2PxgCZvJu_vVuRu_m6H0MvzhOGep98H9FD6JH4NURsMXZNuZRaFP-cFqObzqrOmBN6cP972-bd0YqpoS5uFmbG7her8-vfpj37BdvGqD-</recordid><startdate>19991001</startdate><enddate>19991001</enddate><creator>Lieff, Susan</creator><creator>Olshan, Andrew F.</creator><creator>Werler, Matha</creator><creator>Strauss, Ronald P.</creator><creator>Smith, Jonna</creator><creator>Mitchell, Allen</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U1</scope><scope>7U7</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>19991001</creationdate><title>Maternal Cigarette Smoking during Pregnancy and Risk of Oral Clefts in Newborns</title><author>Lieff, Susan ; Olshan, Andrew F. ; Werler, Matha ; Strauss, Ronald P. ; Smith, Jonna ; Mitchell, Allen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-68849995cfc792d48f0ae1de90d016bea67b75c39ba43dc0ab7494d371a1e6f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>abnormalities</topic><topic>Abnormalities, Multiple - epidemiology</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Boston - epidemiology</topic><topic>Case-Control Studies</topic><topic>cleft lip</topic><topic>Cleft Lip - epidemiology</topic><topic>Cleft lip/palate</topic><topic>cleft palate</topic><topic>Cleft Palate - epidemiology</topic><topic>Confidence Intervals</topic><topic>Confounding Factors (Epidemiology)</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>intrauterine exposure</topic><topic>Iowa - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>multiple</topic><topic>Odds Ratio</topic><topic>Ontario - epidemiology</topic><topic>Philadelphia - epidemiology</topic><topic>Pregnancy</topic><topic>Pregnancy Trimester, First</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Risk Factors</topic><topic>Sex Distribution</topic><topic>smoking</topic><topic>Smoking - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lieff, Susan</creatorcontrib><creatorcontrib>Olshan, Andrew F.</creatorcontrib><creatorcontrib>Werler, Matha</creatorcontrib><creatorcontrib>Strauss, Ronald P.</creatorcontrib><creatorcontrib>Smith, Jonna</creatorcontrib><creatorcontrib>Mitchell, Allen</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Risk Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lieff, Susan</au><au>Olshan, Andrew F.</au><au>Werler, Matha</au><au>Strauss, Ronald P.</au><au>Smith, Jonna</au><au>Mitchell, Allen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Maternal Cigarette Smoking during Pregnancy and Risk of Oral Clefts in Newborns</atitle><jtitle>American journal of epidemiology</jtitle><addtitle>Am J Epidemiol</addtitle><date>1999-10-01</date><risdate>1999</risdate><volume>150</volume><issue>7</issue><spage>683</spage><epage>694</epage><pages>683-694</pages><issn>0002-9262</issn><eissn>1476-6256</eissn><coden>AJEPAS</coden><abstract>The results of previous epidemiologic research on the possible association between maternal smoking during pregnancy and risk of oral clefts in offspring have been inconsistent. This may be due in part to methodological limitations, including imprecise measurement of tobacco use, failure to consider etiologic heterogeneity among types of oral clefts, and confounding. This analysis, based on a large case-control study, further evaluated the effect of first trimester maternal smoking on oral facial cleft risk by examining the dose-response relationship according to specific cleft type and according to whether or not additional malformations were present. A number of factors, including dietary and supplemental folate intake and family history of clefts, were evaluated as potential confounders and effect modifiers. Data on 3, 774 mothers interviewed between 1976 and 1992 by the Slone Epidemiology Unit Birth Defects Study were used. Study subjects were actively ascertained from sites in areas around Boston, Massachusetts and Philadelphia, Pennsylvania; the state of Iowa; and southeastern Ontario, Canada. Cases were infants with isolated defects—cleft lip alone (n = 334), cleft lip and palate (n = 494), or cleft palate alone (n = 244)—and infants with clefts plus (+) additional malformations: cleft lip+ (n = 58), cleft lip and palate+ (n = 140), or cleft palate+ (n = 209). Controls were infants with defects other than clefts, excluding defects possibly associated with maternal cigarette use. There were no associations with maternal smoking for any oral cleft group, except for a positive dose response among infants with cleft lip and palate+ (for light smokers, odds ratio (OR) = 1.09 (95% confidence interval (Cl): 0.6, 1.9); for moderate smokers, OR = 1.84 (95% Cl: 1.2, 2.9); and for heavy smokers, OR = 1.85 (95% Cl: 1.0, 3.5), relative to nonsmokers). This finding may be related to the additional malformations rather than to the cleft itself. Am J Epidemiol 1999; 150: 683-94.</abstract><cop>Cary, NC</cop><pub>Oxford University Press</pub><pmid>10512422</pmid><doi>10.1093/oxfordjournals.aje.a010071</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | abnormalities Abnormalities, Multiple - epidemiology Adult Biological and medical sciences Boston - epidemiology Case-Control Studies cleft lip Cleft Lip - epidemiology Cleft lip/palate cleft palate Cleft Palate - epidemiology Confidence Intervals Confounding Factors (Epidemiology) Diseases of mother, fetus and pregnancy Female Gynecology. Andrology. Obstetrics Humans Infant, Newborn intrauterine exposure Iowa - epidemiology Male Medical sciences multiple Odds Ratio Ontario - epidemiology Philadelphia - epidemiology Pregnancy Pregnancy Trimester, First Pregnancy. Fetus. Placenta Risk Factors Sex Distribution smoking Smoking - epidemiology |
| title | Maternal Cigarette Smoking during Pregnancy and Risk of Oral Clefts in Newborns |
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