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Jia ZL, Shi B, Chen CH, Shi JY, Wu J, Xu X. Maternal malnutrition, environmental exposure during pregnancy and the risk of non-syndromic orofacial clefts. Oral Dis 2011; 17:584-9. [DOI: 10.1111/j.1601-0825.2011.01810.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Leonardi-Bee J, Britton J, Venn A. Secondhand smoke and adverse fetal outcomes in nonsmoking pregnant women: a meta-analysis. Pediatrics 2011; 127:734-41. [PMID: 21382949 DOI: 10.1542/peds.2010-3041] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the risk of adverse fetal outcomes of secondhand smoke exposure in nonsmoking pregnant women. METHODS This was a systematic review and meta-analysis in accordance with Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. We searched Medline and Embase (to March 2009) and reference lists for eligible studies; no language restrictions were imposed. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by using random-effect models. Our search was for epidemiologic studies of maternal exposure to secondhand smoke during pregnancy in nonsmoking pregnant women. The main outcome measures were spontaneous abortion, perinatal and neonatal death, stillbirth, and congenital malformations. RESULTS We identified 19 studies that assessed the effects of secondhand smoke exposure in nonsmoking pregnant women. We found no evidence of a statistically significant effect of secondhand smoke exposure on the risk of spontaneous abortion (OR: 1.17 [95% CI: 0.88-1.54]; 6 studies). However, secondhand smoke exposure significantly increased the risk of stillbirth (OR: 1.23 [95% CI: 1.09-1.38]; 4 studies) and congenital malformation (OR: 1.13 [95% CI: 1.01-1.26]; 7 studies), although none of the associations with specific congenital abnormalities were individually significant. Secondhand smoke exposure had no significant effect on perinatal or neonatal death. CONCLUSIONS Pregnant women who are exposed to secondhand smoke are estimated to be 23% more likely to experience stillbirth and 13% more likely give birth to a child with a congenital malformation. Because the timing and mechanism of this effect is not clear, it is important to prevent secondhand smoke exposure in women before and during pregnancy.
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Affiliation(s)
- Jo Leonardi-Bee
- UK Centre for Tobacco Control Studies, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, United Kingdom.
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Jia ZL, Shi B, Xu X, Kong XL. Interactions Between Small Ubiquitin-Like Modifier 1 and Nonsyndromic Orofacial Clefts. DNA Cell Biol 2011; 30:235-40. [PMID: 21189065 DOI: 10.1089/dna.2010.1110] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Zhong-Lin Jia
- State Key Laboratory of Oral Disease, Sichuan University, Chengdu, The People's Republic of China
- Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, The People's Republic of China
| | - Bing Shi
- State Key Laboratory of Oral Disease, Sichuan University, Chengdu, The People's Republic of China
- Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, The People's Republic of China
| | - Xue Xu
- State Key Laboratory of Oral Disease, Sichuan University, Chengdu, The People's Republic of China
- Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, The People's Republic of China
| | - Xiang-Li Kong
- State Key Laboratory of Oral Disease, Sichuan University, Chengdu, The People's Republic of China
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Current National Incidence, Trends, and Health Care Resource Utilization of Cleft Lip–Cleft Palate. Plast Reconstr Surg 2011; 127:1255-1262. [DOI: 10.1097/prs.0b013e3182043af6] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jia ZL, Li Y, Meng T, Shi B. Association Between Polymorphisms at Small Ubiquitin-Like Modifier 1 and Nonsyndromic Orofacial Clefts in Western China. DNA Cell Biol 2010; 29:675-80. [PMID: 20738159 DOI: 10.1089/dna.2010.1034] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Zhong-Lin Jia
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
| | - Yang Li
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
| | - Tian Meng
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
| | - Bing Shi
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, P.R. China
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Maternal cigarette smoking and the associated risk of having a child with orofacial clefts in China: a case-control study. J Craniomaxillofac Surg 2010; 39:313-8. [PMID: 20832329 DOI: 10.1016/j.jcms.2010.07.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 05/01/2010] [Accepted: 07/21/2010] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND We investigated whether maternal and paternal cigarette smoking during early pregnancy could increase the risk of delivering an infant with an orofacial cleft. METHODS A case-control study was carried out in China. 304 infants born with an isolated nonsyndromic oral cleft and 453 non-malformed controls were recruited as participants and their exposure to smoke plus family history data were collected. RESULTS The relative odds ratios of maternal smoking to cause an orofacial cleft in infant increased for 3.30 (95% CI, 1.17-9.33) in CLO and 3.12 (95% CI, 1.24-7.84) in CLP from 1 to 10 cigarettes per day before pregnancy. The unadjusted odds ratio is 3.64 (95% CI, 1.01-13.19) and the adjusted OR is 7.00 (95% CI, 1.44-34.13) in CLO from 1 to 10 cigarettes during the first trimester. Paternal smoking in the periconceptional period was strongly associated with all subtypes of CLP. The association with medium ETS (2-6h) at home or at work was strongest for infants with all OFCs in the periconceptional period from 1 month before pregnancy through the end of the first trimester. CONCLUSION This study confirmed the modest association between maternal smoking and orofacial clefts.
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Salmasi G, Grady R, Jones J, McDonald SD. Environmental tobacco smoke exposure and perinatal outcomes: a systematic review and meta-analyses. Acta Obstet Gynecol Scand 2010; 89:423-441. [PMID: 20085532 DOI: 10.3109/00016340903505748] [Citation(s) in RCA: 158] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND While active maternal tobacco smoking has well established adverse perinatal outcomes, the effects of passive maternal smoking, also called environmental tobacco exposure (ETS), are less well studied and less consistent. OBJECTIVE To determine to the effect of ETS on perinatal outcomes. SEARCH STRATEGY Medline, EMBASE and reference lists were searched. SELECTION CRITERIA Studies comparing ETS-exposed pregnant women with those unexposed which adequately addressed active maternal smoking. DATA COLLECTION AND ANALYSIS Two reviewers independently assessed titles, abstracts, full studies, extracted data and assessed quality. Dichotomous data were pooled using odds ratios (OR) and continuous data with weighted mean differences (WMD) using a random effects model. MAIN RESULTS Seventy-six articles were included with a total of 48,439 ETS-exposed women and 90,918 unexposed women. ETS-exposed infants weighed less [WMD -60 g, 95% confidence interval (CI) -80 to -39 g], with a trend towards increased low birthweight (LBW, < 2,500 g; RR 1.16; 95% CI 0.99-1.36), although the duration of gestation and preterm delivery were similar (WMD 0.02 weeks, 95% CI -0.09 to 0.12 weeks and RR 1.07; 95% CI 0.93-1.22). ETS-exposed infants had longer infant lengths (1.75 cm; 95% CI 1.37-2.12 cm), increased risks of congenital anomalies (OR 1.17; 95% CI 1.03-1.34) and a trend towards smaller head circumferences (-0.11 cm; 95% CI -0.22 to 0.01 cm). CONCLUSIONS ETS-exposed women have increased risks of infants with lower birthweight, congenital anomalies, longer lengths, and trends towards smaller head circumferences and LBW.
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Affiliation(s)
- Giselle Salmasi
- Department of Health Sciences, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
| | - Rosheen Grady
- Department of Health Research Methodology, McMaster University, 1200 Main St. West, Hamilton, Ontario, Canada L8N 3Z5
| | - Jennifer Jones
- Department of Health Sciences, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
| | - Sarah D McDonald
- Division of Maternal-Fetal Medicine, Departments of Obstetrics & Gynecology, Diagnostic Imaging, and Clinical Epidemiology & Biostatistics, McMaster University, 1200 Main St. West, Hamilton, Ontario, Canada L8N 3Z5
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Baroni T, Bellucci C, Lilli C, Pezzetti F, Carinci F, Lumare E, Palmieri A, Stabellini G, Bodo M. Human cleft lip and palate fibroblasts and normal nicotine-treated fibroblasts show altered in vitro expressions of genes related to molecular signaling pathways and extracellular matrix metabolism. J Cell Physiol 2010; 222:748-56. [PMID: 20020508 DOI: 10.1002/jcp.22006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Nonsyndromic cleft lip with or without cleft palate (CLP) is a frequent craniofacial malformation caused by both genetic and environmental factors. Maternal smoking during pregnancy is a known risk factor, due to the teratogenic role of nicotine. To assess and compare the impact of CLP and nicotine, we studied the quantitative expression of genes involved in signaling pathways and extracellular matrix (ECM) metabolism in human normal nicotine-treated (NicN) and CLP fibroblasts compared to normal control (CTRL) cells. Palatal fibroblast cultures from seven CLP children and seven age-matched CTRL subjects were established and subconfluent cells incubated for 24 h without (CTRL and CLP fibroblasts) or with (NicN fibroblasts) 0.6 mM nicotine. Gene expressions were analyzed by real-time quantitative PCR. For the first time, a regulated cholinergic signaling in our human fibroblasts in vitro was demonstrated. Members of TGF-beta, retinoic acid (RA), and GABA-ergic signaling systems were also differently regulated. Among the ECM genes, fibronectin, syndecan, integrin alpha2, and MMP13 genes were concordantly modulated, while integrin beta5, and decorin genes were discordantly modulated. Interestingly, nicotine treatment regulated gene expressions of CD44 and CLPTM1, two candidate genes for CLP. Our findings show a positive association between nicotine treatment and CLP phenotype. Results suggest that nicotine deranges normal palate development, which might contribute to the development of a CLP malformative phenotype, through the impairment of some important signaling systems and ECM composition.
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Affiliation(s)
- Tiziano Baroni
- Department of Experimental Medicine and Biochemical Sciences, University of Perugia, via del Giochetto, 06100 Perugia, Italy.
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Jia ZL, Li Y, Chen CH, Li S, Wang Y, Zheng Q, Shi B. Association Among Polymorphisms at MYH9, Environmental Factors, and Nonsyndromic Orofacial Clefts in Western China. DNA Cell Biol 2010; 29:25-32. [PMID: 19891592 DOI: 10.1089/dna.2009.0935] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Zhong-Lin Jia
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Yang Li
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Chun-Hui Chen
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Sheng Li
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Yan Wang
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Qian Zheng
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Bing Shi
- State Key Laboratory of Oral Disease and Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
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Abstract
Clefts of the lip and palate are generally divided into two groups, isolated cleft palate and cleft lip with or without cleft palate, representing a heterogeneous group of disorders affecting the lips and oral cavity. These defects arise in about 1.7 per 1000 liveborn babies, with ethnic and geographic variation. Effects on speech, hearing, appearance, and psychology can lead to longlasting adverse outcomes for health and social integration. Typically, children with these disorders need multidisciplinary care from birth to adulthood and have higher morbidity and mortality throughout life than do unaffected individuals. This Seminar describes embryological developmental processes, epidemiology, known environmental and genetic risk factors, and their interaction. Although access to care has increased in recent years, especially in developing countries, quality of care still varies substantially. Prevention is the ultimate objective for clefts of the lip and palate, and a prerequisite of this aim is to elucidate causes of the disorders. Technological advances and international collaborations have yielded some successes.
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Affiliation(s)
- Peter A Mossey
- Department of Dental and Oral Health, University of Dundee, Dental Hospital and School, Dundee, UK.
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Analysis of interactions between genetic variants of BMP4 and environmental factors with nonsyndromic cleft lip with or without cleft palate susceptibility. Int J Oral Maxillofac Surg 2009; 39:50-6. [PMID: 19914800 DOI: 10.1016/j.ijom.2009.10.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Revised: 06/06/2009] [Accepted: 10/16/2009] [Indexed: 01/10/2023]
Abstract
A hospital-based case-control study was conducted to identify interactions between the 538(T-->C) polymorphic site of bone morphogenetic protein 4 gene (BMP4T538C) and exposures in pregnancy with nonsyndromic cleft lip, with or without cleft palate (nsCL/P). Associations between offspring polymorphism of BMP4T538C, paternal smoking, paternal high-risk drinking, maternal passive smoking, and maternal multivitamin supplement with nsCL/P were analyzed by logistic regression analysis. BMP4T538C polymorphism, maternal passive smoking exposures and maternal multivitamin use were associated with the risk of nsCL/P but paternal smoking and paternal high-risk drinking were not. Gene-environment interactions were analyzed using the multifactor dimensionality reduction (MDR) method. The two-factor model including maternal passive smoking and BMP4T538C, was the best for predicting nsCL/P risk with a maximum cross-validation consistency (10/10) and a maximum average testing accuracy(0.605; P<0.0001). The findings suggested that: BMP4T538C could be used as a genetic susceptibility marker for nsCL/P; maternal passive smoking exposure is a risk factor for nsCL/P; maternal multivitamin supplements are a protective factor; the synergistic effect of BMP4T538C and maternal passive smoking could provide a new tool for identifying individuals at high risk of nsCL/P, and provides additional evidence that nsCL/P is determined by genetic and environmental factors.
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Best D. From the American Academy of Pediatrics: Technical report--Secondhand and prenatal tobacco smoke exposure. Pediatrics 2009; 124:e1017-44. [PMID: 19841110 DOI: 10.1542/peds.2009-2120] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Secondhand tobacco smoke (SHS) exposure of children and their families causes significant morbidity and mortality. In their personal and professional roles, pediatricians have many opportunities to advocate for elimination of SHS exposure of children, to counsel tobacco users to quit, and to counsel children never to start. This report discusses the harms of tobacco use and SHS exposure, the extent and costs of tobacco use and SHS exposure, and the evidence that supports counseling and other clinical interventions in the cycle of tobacco use. Recommendations for future research, policy, and clinical practice change are discussed. To improve understanding and provide support for these activities, the harms of SHS exposure are discussed, effective ways to eliminate or reduce SHS exposure are presented, and policies that support a smoke-free environment are outlined.
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Bayesian methods for correcting misclassification: an example from birth defects epidemiology. Epidemiology 2009; 20:27-35. [PMID: 19234399 DOI: 10.1097/ede.0b013e31818ab3b0] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cleft lip with or without cleft palate (CL/P) and cleft palate only (CPO) are common congenital malformations. Numerous epidemiologic studies have shown an increased risk for orofacial clefts among children whose mothers smoked during early pregnancy; however, there is concern that the results of these studies may have been biased because of exposure misclassification. The purpose of this study is to use previous research on the reliability of self-reported cigarette smoking to produce corrected point estimates (and associated credible intervals) of the effect of maternal smoking on children's risk of clefts. METHODS We accounted for misclassification using 4 Bayesian models that made different assumptions about the sensitivity and specificity of self-reported maternal smoking data. We used results from previous studies to specify the prior distributions for sensitivity and specificity of reporting and used Markov chain Monte Carlo algorithms to calculate the posterior distribution of the effect of maternal smoking on children's risk for CL/P and CPO. RESULTS After correcting for potential sources of misclassification in data from the National Birth Defects Prevention Study, we found an increased risk of CL/P among children born to mothers who smoked during early pregnancy (posterior odds ratio [OR] = 1.6, 95% credible interval = 1.1-2.2). The posterior effect of smoking on CPO provided less evidence of effect (posterior OR = 1.1, 95% credible interval = 0.7-1.7). CONCLUSION Our results lend some credibility to the hypothesis that periconceptional maternal smoking increases the risk of a child being born with CL/P. The results concerning CPO provide no overall evidence of effect, although the estimates were relatively imprecise. We suggest that future research should emphasize validity studies, especially those of differential reporting, rather than replicating existing analyses of the relationship between maternal smoking and clefts. We discuss how our approach is also applicable to evaluating misclassification in a wide range of exposure-outcome scenarios.
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Jia ZL, Li Y, Li L, Wu J, Zhu LY, Yang C, Chen CH, Shi B. Association Among IRF6 Polymorphism, Environmental Factors, and Nonsyndromic Orofacial Clefts in Western China. DNA Cell Biol 2009; 28:249-57. [PMID: 19388848 DOI: 10.1089/dna.2008.0837] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Zhong-Lin Jia
- State Key Laboratory of Oral Disease and the Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Yang Li
- State Key Laboratory of Oral Disease and the Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Ling Li
- State Key Laboratory of Oral Disease and the Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Jun Wu
- State Key Laboratory of Oral Disease and the Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Lu-Ying Zhu
- State Key Laboratory of Oral Disease and the Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Chao Yang
- State Key Laboratory of Oral Disease and the Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Chun-Hui Chen
- State Key Laboratory of Oral Disease and the Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
| | - Bing Shi
- State Key Laboratory of Oral Disease and the Department of Cleft Lip and Palate Surgery, West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China
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Little J, Gilmour M, Mossey PA, FitzPatrick D, Cardy A, Clayton-Smith J, Fryer AE. Folate and Clefts of the Lip and Palate—A U.K.-Based Case-Control Study: Part I: Dietary and Supplemental Folate. Cleft Palate Craniofac J 2008; 45:420-7. [DOI: 10.1597/06-150.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives: We sought to determine the associations between nonsyndromic cleft lip with or without cleft palate (CL−P) and cleft palate only (CP) and maternal intake of dietary folate and supplemental folic acid, in an area where the prevalence at birth of neural tube defects has been high and flour is not fortified with folic acid. Methods: Interviews regarding periconceptional dietary intake and supplement use were completed with the mothers of 112 CL−P cases, 78 CP cases, and 248 unaffected infants. The data were analyzed by logistic regression methods. Results: There was no overall association between CL−P and CP and either energy-adjusted total folate intake or supplemental folic acid use, irrespective of dosage. Conclusion: Overall, higher intakes of total folate do not appear to prevent oral clefts in this population.
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Affiliation(s)
- J. Little
- Human Genome Epidemiology, University of Ottawa, Canada (formerly Professor of Epidemiology, University of Aberdeen, Scotland)
| | - M. Gilmour
- Tayside Centre for General Practice, University of Dundee, Scotland
| | - P. A. Mossey
- Craniofacial Development, University of Dundee, Scotland
| | - D. FitzPatrick
- MRC Human Genetics Unit, Western General Hospital, Edinburgh, Scotland
| | - A. Cardy
- Primary Care, University of Aberdeen, Scotland
| | - J. Clayton-Smith
- Medical Genetics, St Mary's Hospital for Women and Children, Manchester, England
| | - A. E. Fryer
- Medical Genetics, Liverpool Women's Hospital, Liverpool, England
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Lie RT, Wilcox AJ, Taylor J, Gjessing HK, Saugstad OD, Aabyholm F, Vindenes H. Maternal smoking and oral clefts: the role of detoxification pathway genes. Epidemiology 2008; 19:606-15. [PMID: 18449058 PMCID: PMC5560035 DOI: 10.1097/ede.0b013e3181690731] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND There is evidence for an effect of cigarette smoking on risk of oral clefts. There are also hypothetical pathways for a biologic effect involving toxic chemicals in cigarette smoke. METHODS We performed a combined case-control and family-triad study of babies born with oral clefts in Norway in the period 1996 to 2001, with 88% participation among cases (n = 573) and 76% participation among controls (n = 763). Mothers completed a questionnaire 4 months after birth of the baby. DNA was collected from parents and children, and assayed for genes related to detoxification of compounds of cigarette smoke (NAT1, NAT2, CYP1A1, GSTP1, GSTT1, and GSTM1). RESULTS For isolated cleft lip (with or without cleft palate) there was a dose-response effect of smoking in the first trimester. The odds ratio rose from 1.6 (95% confidence interval = 1.0-2.5) for passive smoking to 1.9 (0.9-4.0) for mothers who smoked more than 10 cigarettes per day. There was little evidence of an association with cleft palate. Genetic analyses used both case-control and family-triad data. In case-triads we found an association between a NAT2 haplotype and isolated cleft lip (relative risk of 1.6 with 1 copy of the allele and 2.5 with 2 copies), but with little evidence of interaction with smoking. Other genes did not show associations, and previously described interactions with smoking were not confirmed. CONCLUSION First-trimester smoking was clearly associated with risk of cleft lip. This effect was not modified by variants of genes related to detoxification of compounds of cigarette smoke.
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Affiliation(s)
- Rolv T Lie
- Department of Public Health and Primary Health Care, University of Bergen, Norway.
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The Fetal Cleft Palate: V. Elucidation of the Mechanism of Palatal Clefting in the Congenital Caprine Model. Plast Reconstr Surg 2008; 121:1328-1334. [DOI: 10.1097/01.prs.0000302460.90076.96] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wang L, Pinkerton KE. Air pollutant effects on fetal and early postnatal development. ACTA ACUST UNITED AC 2007; 81:144-54. [PMID: 17963272 DOI: 10.1002/bdrc.20097] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Numerical research on the health effects of air pollution has been published in the last decade. Epidemiological studies have shown that children's exposure to air pollutants during fetal development and early postnatal life is associated with many types of health problems including abnormal development (low birth weight [LBW], very low birth weight [VLBW], preterm birth [PTB], intrauterine growth restriction [IUGR], congenital defects, and intrauterine and infant mortality), decreased lung growth, increased rates of respiratory tract infections, childhood asthma, behavioral problems, and neurocognitive decrements. This review focuses on the health effects of major outdoor air pollutants including particulates, carbon monoxide (CO), sulfur and nitrogen oxides (SO(2), NOx), ozone, and one common indoor air pollutant, environmental tobacco smoke (ETS). Animal data is presented that demonstrate perinatal windows of susceptibility to sidestream smoke, a surrogate for ETS, resulting in altered airway sensitivity and cell type frequency. A study of neonatal monkeys exposed to sidestream smoke during the perinatal period and/or early postnatal period that resulted in an altered balance of Th1-/Th2-cytokine secretion, skewing the immune response toward the allergy-associated Th2 cytokine phenotype, is also discussed.
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Affiliation(s)
- Lei Wang
- Center for Health and the Environment, University of California-Davis, Old Davis Road, Davis, CA 95616, USA
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Mossey PA, Davies JA, Little J. Prevention of orofacial clefts: does pregnancy planning have a role? Cleft Palate Craniofac J 2007; 44:244-50. [PMID: 17477752 DOI: 10.1597/06-002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the association between pregnancy planning and orofacial clefts in the United Kingdom. DESIGN Case-control study. SETTING Scotland and the Manchester and Merseyside regions of England. PARTICIPANTS One hundred and ninety-one children born with nonsyndromic orofacial cleft, 1997 to 2000, and 247 controls. MAIN OUTCOME MEASURE Cleft lip with and without cleft palate, and cleft palate. RESULTS There was an inverse association between planning for pregnancy and orofacial cleft in the offspring (odds ratio [OR] = 0.51, 95% confidence interval [CI] = 0.33-0.79). An unplanned pregnancy together with smoking in the first trimester of pregnancy resulted in almost treble the risk of a child with an orofacial cleft when compared with those who planned their pregnancy and did not smoke (OR = 2.92, CI = 1.50-5.65). CONCLUSIONS Planned pregnancies were associated with a lower risk of orofacial clefts. Isolation of the elements of pregnancy planning implicated in these results is difficult. Current preconception advice needs to reach a wider audience; however, for maximum impact, efforts are needed to reduce the numbers of unplanned pregnancies.
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Honein MA, Rasmussen SA, Reefhuis J, Romitti PA, Lammer EJ, Sun L, Correa A. Maternal Smoking and Environmental Tobacco Smoke Exposure and the Risk of Orofacial Clefts. Epidemiology 2007; 18:226-33. [PMID: 17202867 DOI: 10.1097/01.ede.0000254430.61294.c0] [Citation(s) in RCA: 190] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Margaret A Honein
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Spezielle Arzneimitteltherapie in der Schwangerschaft. ARZNEIVERORDNUNG IN SCHWANGERSCHAFT UND STILLZEIT 2006. [PMCID: PMC7271219 DOI: 10.1016/b978-343721332-8.50004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cournot MP, Assari-Merabtene F, Vauzelle-Gardier C, Eléfant E. Quels sont les risques d’embryo-fœtopathie liés à l’exposition au tabagisme pendant la grossesse ? ACTA ACUST UNITED AC 2005. [DOI: 10.1016/s0368-2315(05)82979-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Saito T, Cui XM, Yamamoto T, Shiomi N, Bringas P, Shuler CF. Effect of N'-nitrosonornicotine (NNN) on murine palatal fusion in vitro. Toxicology 2005; 207:475-85. [PMID: 15664274 DOI: 10.1016/j.tox.2004.10.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2004] [Revised: 10/29/2004] [Accepted: 10/31/2004] [Indexed: 11/24/2022]
Abstract
Maternal smoking has been linked to an increased risk for orofacial clefts. N'-nitrosonornicotine (NNN) is one of the tobacco-specific nitrosamines that has been shown to be linked to the deleterious effects of tobacco and could be linked to the formation of cleft palate birth defects. The effect of NNN on palatal fusion was examined using an in vitro organ culture model of palatal development. The organ cultures were exposed to NNN (0.01, 0.1, 1, 10 and 100 mM) and the effects on palatal development characterized at defined points. Palatal fusion was evaluated at embryonic day 13 (E13)+72 h by characterizing the remaining medial edge epithelium (MEE) and determining the extent of fusion compared to controls. The NNN-treated group (1 mM) had more MEE remaining in the palatal midline than the untreated group at E13+72 h (P<0.05). Changes in cell proliferation in the MEE resulting from NNN exposure were examined by BrdU incorporation in replicating DNA. Changes in the pattern of MEE cell death were examined by TUNEL. BrdU incorporation and TUNEL staining showed that the NNN (1 mM)-treated palates had more MEE cell proliferation and less apoptosis than the untreated-palates at E13+24 h (P<0.05). The mechanism altered by NNN was further evaluated by characterizations of extracellular signal-regulated kinase (ERK) 1/2, p38 and c-jun amino-terminal kinase (JNK). NNN at 1 mM induced ERK1/2 phosphorylation, but reduced p38 phosphorylation (P<0.05, P<0.01, respectively) in the MEE. The results suggest that NNN inhibited palatal fusion by effects on cell proliferation and MEE cell death.
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Affiliation(s)
- Takashi Saito
- Center for Craniofacial Molecular Biology, School of Dentistry, University of Southern California, Los Angeles, CA 90033-9062, USA
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