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Sun B, Reynolds KS, Garland MA, McMahon M, Saha SK, Zhou CJ. Epigenetic implications in maternal diabetes and metabolic syndrome-associated risk of orofacial clefts. Birth Defects Res 2023; 115:1835-1850. [PMID: 37497595 DOI: 10.1002/bdr2.2226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/12/2023] [Accepted: 07/07/2023] [Indexed: 07/28/2023]
Abstract
Orofacial clefts (OFCs) are one of the most common types of structural birth defects. The etiologies are complicated, involving with genetic, epigenetic, and environmental factors. Studies have found that maternal diabetes and metabolic syndrome are associated with a higher risk of OFCs in offspring. Metabolic syndrome is a clustering of several disease risk factors, including hyperglycemia, dyslipidemia, obesity, and hypertension. Metabolic disease during pregnancy can increase risk of adverse outcomes and significantly influence fetal development, including orofacial formation and fusion. An altered metabolic state may contribute to developmental disorders or congenital defects including OFCs, potentially through epigenetic modulations, such as histone modification, DNA methylation, and noncoding RNA expression to alter activities of critical morphogenetic signaling or related developmental genes. This review summarizes the currently available evidence and underlying mechanisms of how the maternal metabolic syndrome is associated with OFCs in mostly human and some animal studies. It may provide a better understanding of the interactions between intrauterine metabolic status and fetal orofacial development which might be applied toward prevention and treatments of OFCs.
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Affiliation(s)
- Bo Sun
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, California, USA
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, California, USA
| | - Kurt S Reynolds
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, California, USA
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, California, USA
| | - Michael A Garland
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, California, USA
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, California, USA
| | - Moira McMahon
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, California, USA
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, California, USA
| | - Subbroto K Saha
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, California, USA
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, California, USA
| | - Chengji J Zhou
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, California, USA
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, California, USA
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de Andrade RS, Oliveira FESD, Martelli DRB, de Barros LM, Martelli Júnior H. Maternal consumption of caffeine and second-hand tobacco smoke as risk factors for the development of oral clefts. Clinics (Sao Paulo) 2023; 78:100266. [PMID: 37567043 PMCID: PMC10432903 DOI: 10.1016/j.clinsp.2023.100266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVE The aim of this case-control study was to investigate environmental factors, such as caffeine, folic acid, nutritional iron supplementation, multivitamin complexes, alcohol, and tobacco (second-hand smoking), which have been described as risk factors for the development of oral clefts. METHODS This case-control study employed convenience sampling and included 409 mothers: 132 with children with oral clefts (cases) and 277 with children without oral clefts (controls). The age range of the children in both groups was 0 to 2 years. A questionnaire was administered to each mother to inquire about their habits and food consumption during the first trimester of pregnancy. RESULTS Folic acid supplementation was observed in 116 (87.8%) of the case group (p < 0.001) and 271 (97.8%) of the control group. Regarding the use of ferrous sulfate, 114 (86.3%) of the case group and 271 (97.8%) of the control group reported using it. In the case group, 84 (63.6%) mothers reported being exposed to second-hand smoke, and 5 (3.7%) reported alcohol consumption (p = 0.797). In terms of caffeine consumption, 127 mothers (95.4%) in the case group consumed it (p = 0.13), while 247 (88.8%) reported consumption in the control group. CONCLUSIONS The results suggest a direct relationship between secondhand smoke, alcohol consumption, and the lack of maternal supplementation with oral clefts.
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Affiliation(s)
| | - Fabrício Emanuel Soares de Oliveira
- Postgraduate Program in Primary Health Care, Unimontes, Montes Claros, Minas Gerais, Brazil; Postgraduate Program in Health Sciences, Unimontes, Montes Claros, Minas Gerais, Brazil.
| | | | - Letízia Monteiro de Barros
- José do Rosário Vellano University, Institute of Dentistry and Health Sciences, Periodontics, Alfenas, Minas Gerais, Brazil
| | - Hercílio Martelli Júnior
- Postgraduate Program in Primary Health Care, Unimontes, Montes Claros, Minas Gerais, Brazil; Postgraduate Program in Health Sciences, Unimontes, Montes Claros, Minas Gerais, Brazil
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3
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Liu C, Wang D, Jin L, Zhang J, Meng W, Jin L, Shang X. The relationship between maternal periconceptional micronutrient supplementation and non-syndromic cleft lip/palate in offspring. Birth Defects Res 2023; 115:545-554. [PMID: 36595654 DOI: 10.1002/bdr2.2146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study aimed to explore the relationship between maternal periconceptional supplementation with folic acid only (FAO) or with multiple micronutrients containing folic acid (MMFA) and non-syndromic cleft lip/palate in offspring. METHOD The data came from a prenatal health care system and a birth defects surveillance system in Beijing, China, from 2013 to 2018. Information on maternal FAO/MMFA supplementation was collected by questionnaire in the first trimester, and data on cleft lip/palate were collected at delivery or termination of pregnancy. Inverse probability weighting (IPW) by the propensity score to adjust for the confounders and Poisson regression model was used to estimate risk ratios (RRs) and their 95% confidence intervals (CIs). RESULTS A total of 63,969 participants were included in the study. Compared to the no-supplementation group, the adjusted RR for the supplementation group was 0.51 (95% CI: 0.40, 0.64). And the adjusted RRs for FAO and MMFA compared to the no-supplementation group were 0.56 (95% CI: 0.40, 0.76) and 0.48 (95% CI: 0.35, 0.65), respectively. Compared to supplement FAO and MMFA with less than 8 days out of 10 days, the adjusted RRs for FAO and MMFA with 8 or more days out of 10 days were 1.17 (95% CI: 0.78, 1.75), and 2.05 (95% CI: 1.37, 3.31), respectively. CONCLUSION Maternal supplementation with micronutrients, either FAO or MMFA, during the periconceptional period can reduce the risk for non-syndromic cleft lip/palate in offspring. However, women should be more cautious with MMFA supplementation.
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Affiliation(s)
- Chunyi Liu
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Di Wang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Lei Jin
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Jie Zhang
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Wenying Meng
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Lei Jin
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Xuejun Shang
- Department of Andrology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China.,Nanjing School of Clinical Medicine, Southern Medical University, Nanjing, China
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Abstract
This chapter reviews the evidence of gene×environment interactions (G×E) in the etiology of orofacial cleft birth defects (OFCs), specifically cleft lip (CL), cleft palate (CP), and cleft lip with or without cleft palate (CL/P). We summarize the current state of our understanding of the genetic architecture of nonsyndromic OFCs and the evidence that maternal exposures during pregnancy influence risk of OFCs. Further, we present possible candidate gene pathways for these exposures including metabolism of folates, metabolism of retinoids, retinoic acid receptor signaling, aryl hydrocarbon receptor signaling, glucocorticoid receptor signaling, and biotransformation and transport. We review genes in these pathways with prior evidence of association with OFCs, genes with evidence from prior candidate gene G×E studies, and genes identified from genome-wide searches specifically for identifying G×E. Finally, we suggest future directions for G×E research in OFCs.
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Affiliation(s)
- Mary L Marazita
- Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, PA, United States; Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, United States; Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States; Clinical and Translational Science Institute, Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
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Purohit MR, Saikrishna L, Verma H, Bhaskar LVKS, Hussain SA. Association Between MTHFD1 1958G > A Variant and non-Syndromic Cleft lip and Palate: An Updated Meta-Analysis. Cleft Palate Craniofac J 2021; 59:1422-1427. [PMID: 34904448 DOI: 10.1177/10556656211046486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Non-syndromic cleft lip and palate (NSCLP) is one of the most common and challenging congenital deformities worldwide. Previous research has linked the methylenetetrahydrofolate dehydrogenase1 (MTHFD1) gene to orofacial cleft (OFC) susceptibility via a complex metabolism. Studies analyzing the MTHFD1 1958G > A variant and NSCLP are contradictory. This study aims to evaluate the association between the MTHFD1 1958G > A variant and NSCLP by meta-analysis. METHODS PubMed, Web of Science, MEDLINE, and Google Scholar databases were searched to retrieve the eligible studies. A fixed- or random-effect model was used to calculate pooled odds ratio (OR) and 95% confidence interval (CI). All analyses were calculated by Metagenyo software. To detect heterogeneity, the Cochrane Q and I2 statistics were used. The publication bias was estimated using funnel plots and Egger's test. RESULTS Our study suggested that the MTHFD1 1958G > A variant allele "A" does not appear to increase the risk of NSCLP (A vs G random effect model: Overall P = .501, OR = 1.07, CI = 0.88-1.31; Asians P = .245, OR = 1.29, CI = 0.84-1.97; Caucasians P = .658, OR = 0.95, CI = 0.76-1.19). Similarly, mutant genotypes also did not exhibit increased risk for NSCLP in the overall populations as well in subgroup analysis by ethnicity (AA + AG vs GG: Overall P = .684, OR = 1.06, CI = 0.80-1.39; Asians P = .240, OR = 1.47, CI = 0.77-2.78; Caucasians P = .923, OR = 0.99, CI = 0.85-1.16). CONCLUSIONS Our data suggest no association between the MTHFD1 1958G > A variant and NSCLP. Additional well-designed studies are needed to better understand the role of MTHFD1 polymorphisms in the etiopathogenesis of NSCLP.
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Affiliation(s)
- Manas R Purohit
- Department of Zoology, 28718Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | | | - Henu Verma
- Department of Immunopathology, Institute of Lungs Biology and Disease, 518741Comprehensive Pneumology Center, Helmholtz Zentrum, 85764 Neuherberg, Munich, Germany
| | - L V K S Bhaskar
- Department of Zoology, 28718Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | - Syed A Hussain
- Department of Plastic Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
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Xu W, Yi L, Deng C, Zhao Z, Ran L, Ren Z, Zhao S, Zhou T, Zhang G, Liu H, Dai L. Maternal periconceptional folic acid supplementation reduced risks of non-syndromic oral clefts in offspring. Sci Rep 2021; 11:12316. [PMID: 34112890 PMCID: PMC8192944 DOI: 10.1038/s41598-021-91825-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/01/2021] [Indexed: 11/15/2022] Open
Abstract
Maternal periconceptional folic acid supplementation (FAS) has been documented to be associated with decreased risk of nonsyndromic oral clefts (NsOC). However, the results remain inconclusive. In this population-based case–control study of 807 singletons affected by NsOC and 8070 healthy neonates who were born between October 2010 and September 2015 in Chengdu, China, we examined the association of maternal FAS with the risk of nonsyndromic cleft lip with or without cleft palate (NsCL/P), and cleft palate (NsCP). Unconditional logistic regression analysis was used to estimate the crude and adjusted odds ratios (ORs) and 95% confidential intervals (CI). Significant associations were found between maternal periconceptional FAS and decreased risk of NsCL/P (aOR = 0.41, 95% CI 0.33–0.51). This protective effect was also detected for NsCL (aOR = 0.42, 95% CI 0.30–0.58) and NsCLP (aOR = 0.41, 95% CI 0.31–0.54). Both maternal FAS started before and after the last menstrual period (LMP) were inversely associated with NsCL/P (before LMP, aOR = 0.43, 95% CI 0.33–0.56; after LMP, aOR = 0.41, 95% CI 0.33–0.51). The association between NsCP and maternal FAS initiating before LMP was also found (aOR = 0.52, 95% CI 0.30–0.90). The findings suggest that maternal periconceptional FAS can reduce the risk of each subtype of NsCL/P in offspring, while the potential effect on NsCP needs further investigations.
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Affiliation(s)
- Wenli Xu
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, No.17 Section 3 Renminnanlu, Chengdu, 610041, Sichuan, China
| | - Ling Yi
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, No.17 Section 3 Renminnanlu, Chengdu, 610041, Sichuan, China
| | - Changfei Deng
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, No.17 Section 3 Renminnanlu, Chengdu, 610041, Sichuan, China
| | - Ziling Zhao
- Sichuan Provincial Hospital for Women and Children, Affiliated Women and Children's Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Longrong Ran
- Chengdu Women's & Children's Central Hospital, Chengdu, Sichuan, China
| | - Zhihong Ren
- Chengdu Women's & Children's Central Hospital, Chengdu, Sichuan, China
| | - Shunxia Zhao
- Chengdu Women's & Children's Central Hospital, Chengdu, Sichuan, China
| | - Tianjin Zhou
- Sichuan Provincial Hospital for Women and Children, Affiliated Women and Children's Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Gang Zhang
- Sichuan Provincial Hospital for Women and Children, Affiliated Women and Children's Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Hanmin Liu
- Pediatric Department, West China Second University Hospital, Sichuan University, No.17 Section 3 Renminnanlu, Chengdu, 610041, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China. .,Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, China.
| | - Li Dai
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, No.17 Section 3 Renminnanlu, Chengdu, 610041, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China. .,Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, China.
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Dhamo B, Jaddoe VWV, Steegers EAP, Wolvius EB, Ongkosuwito EM. The association of maternal folic acid supplementation and prenatal folate and vitamin B12 concentrations with child dental development. Community Dent Oral Epidemiol 2021; 49:445-453. [PMID: 33486813 PMCID: PMC8518742 DOI: 10.1111/cdoe.12620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 01/05/2021] [Accepted: 01/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Low folic acid, folate and vitamin B12 might affect tooth formation and mineralization. The conversion of folic acid into folate is catalysed by the methylenetetrahydrofolate (MTHFR) enzyme which is encoded by the MTHFR gene. Among 3728 mothers and their 10-year-old children from the Generation R Study, we investigated associations of maternal folic acid supplementation and prenatal folate and vitamin B12 concentrations with child dental development. Secondly, we checked the modifying effect of MTHFR-C677T polymorphism. METHODS Information on folic acid supplementation was obtained by questionnaires. Concentrations of folate and vitamin B12 were measured from venous samples taken in early pregnancy. Developmental stages of teeth were defined by the Demirjian method at the age-10 assessment. In addition, dental age of the children was calculated using the Dutch standard. GLM and multivariate linear regression models were built to study the associations. RESULTS Folic acid supplementation started when pregnancy was known (β = -0.09; 95% CI: -0.17, -0.01) and folic acid supplementation started prior to known pregnancy (β = -0.12; 95% CI: -0.20, -0.04) were both associated with decelerated dental development by 1-2 months lower dental age of 10-year-old children. Folate (β = -0.02, 95% CI: -0.05, 0.02) and vitamin B12 (β = 0.03, 95% CI: -0.00, 0.06) were not associated with dental age. MTHFR-C677T did not modify the associations. CONCLUSIONS Maternal folic acid supplementation delays dental development of children by 1-2 months dental age, whereas maternal folate and vitamin B12 concentrations in early pregnancy do not affect the timing of child dental development.
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Affiliation(s)
- Brunilda Dhamo
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eric A P Steegers
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Obstetrics & Gynecology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eppo B Wolvius
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Edwin M Ongkosuwito
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Zhou Y, Sinnathamby V, Yu Y, Sikora L, Johnson CY, Mossey P, Little J. Folate intake, markers of folate status and oral clefts: An updated set of systematic reviews and meta-analyses. Birth Defects Res 2020; 112:1699-1719. [PMID: 33118705 DOI: 10.1002/bdr2.1827] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/04/2020] [Accepted: 10/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND There has been a longstanding debate about the role of folate in the etiology of orofacial clefts (OFCs). Studies of different measures of nutritional intake or folate status have been done to investigate the possible role of folate in the prevention of OFC. Only one knowledge synthesis has attempted to bring together different types of evidence. The aim of the present work was to update it. METHODS Evidence for associations between OFC and dietary folate, supplement use, folic acid fortification, biomarkers of folate status, and variants of MTHFR (C677T and A1298C) were included. Potentially eligible articles were systematically identified from PubMed, Medline, Embase, and Web of Science (2007-2020) and combined using random-effects meta-analysis when appropriate. Quality assessments were conducted using the Newcastle-Ottawa scale and Cochrane's risk of bias tool. RESULTS Sixty-four studies published since the previous knowledge synthesis were identified, with eight of these identified through a supplementary search from October, 2018 to August, 2020. There was an inverse association between folic acid-containing supplement use before or during pregnancy and cleft lip with or without cleft palate (CL/P) (OR 0.60, 95% CI 0.51-0.69), with considerable between-study heterogeneity. The prevalence of CL/P showed a small decline post-folic acid fortification in seven studies (OR 0.94, 95% CI 0.86-1.02). No association was found between OFC and genetic markers of folate status. The coronavirus-19 pandemic has threatened food availability globally and therefore there is a need to maintain and even enhance surveillance concerning maternal intake of folate and related vitamins. CONCLUSIONS The risk of non-syndromic OFC was reduced among pregnant women with folic acid-containing supplements during the etiologically relevant period. However, high heterogeneity between included studies, incomplete reporting of population characteristics and variation in timing of exposure and supplement types mean that conclusions should be drawn with caution.
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Affiliation(s)
- Yulai Zhou
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | | | - Yamei Yu
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Lindsey Sikora
- Health Sciences Library, University of Ottawa, Ontario, Canada
| | - Candice Y Johnson
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
| | - Peter Mossey
- School of Dentistry, University of Dundee, Dundee, Scotland.,WHO Collaborating Centre for Craniofacial Anomalies, Dundee, Scotland
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
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Maternal use of folic acid and multivitamin supplements and infant risk of birth defects in Norway, 1999-2013. Br J Nutr 2020; 124:316-329. [PMID: 32238218 DOI: 10.1017/s0007114520001178] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The association between folic acid supplementation and birth defects other than neural tube defects (NTD) remains unclear. We used a log-binomial regression model to investigate if periconceptional folic acid and/or multivitamin use was associated with birth defects in Norway with prospectively collected data from the Medical Birth Registry of Norway (MBRN) during 1999-2013. We used the European Surveillance of Congenital Anomalies (EUROCAT) classification system to define eleven organ-specific major birth defect groups (nervous system, eye, ear-face-neck, cardiovascular system, respiratory system, oral clefts, digestive system, abdominal wall, urinary system, genital organs and limb), with additional subgroups. Fetuses or infants whose mothers used folic acid and/or multivitamin supplements before and during pregnancy were classified as exposed. During the years 1999-2013, 888 294 (99·0 %) live-born infants, 6633 (0·7 %) stillborn infants and 2135 (0·2 %) fetuses from terminated pregnancies due to fetal anomalies were registered in the MBRN. Among the live- and stillborn infants of women who used vitamin supplements compared with infants of non-users, the adjusted relative risk (aRR) was 0·94 (95 % CI 0·91, 0·98) for total birth defects (n 18 382). Supplement use was associated with reduced risk of abdominal wall defects (aRR 0·58; 95 % CI 0·42, 0·80, n 377), genital organ defects (aRR 0·81; 95 % CI 0·72, 0·91, n 2299) and limb defects (aRR 0·81; 95 % CI 0·74, 0·90, n 3409). Protective associations were also suggested for NTD, respiratory system defects and digestive system defects although CI included the null value of 1. During the full study period, statistically significant associations between supplement use and defects in the eye, ear-face-neck, heart or oral clefts were not observed.
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Yoshida S, Takeuchi M, Kawakami C, Kawakami K, Ito S. Maternal multivitamin intake and orofacial clefts in offspring: Japan Environment and Children's Study (JECS) cohort study. BMJ Open 2020; 10:e035817. [PMID: 32234746 PMCID: PMC7170615 DOI: 10.1136/bmjopen-2019-035817] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Orofacial clefts are common birth defects with a lack of strong evidence regarding their association with maternal nutrition. We aimed to determine whether a relationship exists between maternal nutrient or multivitamin intake and orofacial clefts. DESIGN This is a prospective, population-based nationwide cohort study. SETTING The study was conducted in 15 regional centres, consisting of local administrative units and study areas. PARTICIPANTS A total of 98 787 eligible mother-child pairs of the Japan Environment and Children's Study were included. INTERVENTION Exposures were maternal nutrition and the use of supplemental multivitamins in mothers. PRIMARY AND SECONDARY OUTCOME MEASURES Outcomes were the occurrence of any orofacial cleft at birth. Multinomial logistic regression analyses were used to evaluate the association between maternal multivitamin intake and the incidence of orofacial clefts. RESULTS Of the 98 787 children, 69 (0.07%) were diagnosed with cleft lip alone, 113 (0.11%) were diagnosed with cleft lip and palate, and 52 (0.05%) were diagnosed with cleft palate within 1 month after birth. Regarding the total orofacial cleft outcome, statistically significant point estimates of relative risk ratios (RR) were determined for multivitamin intake before pregnancy (RR=1.71; 95% CI 1.06 to 2.77) and during the first trimester (RR=2.00; 95% CI 1.18 to 3.37), but the association was not significant for multivitamin intake after the first trimester (RR=1.34; 95% CI 0.59 to 3.01). Maternal micronutrient intake via food was not associated with the incidence of orofacial clefts in offspring. CONCLUSIONS Intake of multivitamin supplements shortly before conception or during the first trimester of pregnancy was found to be associated with an increased incidence of orofacial clefts at birth. Pregnant women and those intending to become pregnant should be advised of the potential risks of multivitamin supplementation.
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Affiliation(s)
- Satomi Yoshida
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Masato Takeuchi
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Chihiro Kawakami
- Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Shuichi Ito
- Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
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Ki S, Kwon SH, Eum J, Raslan AA, Kim KN, Hwang BJ, Kee Y. 3D light-sheet assay assessing novel valproate-associated cardiotoxicity and folic acid relief in zebrafish embryogenesis. CHEMOSPHERE 2019; 227:551-560. [PMID: 31004822 DOI: 10.1016/j.chemosphere.2019.04.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
Precise in vivo toxicological assays to determine the cardiotoxicity of pharmaceuticals and their waste products are essential in order to evaluate their risks to humans and the environment following industrial release. In the present study, we aimed to develop the sensitive imaging-based cardiotoxicity assay and combined 3D light-sheet microscopy with a zebrafish model to identify hidden cardiovascular anomalies induced by valproic acid (VPA) exposure. The zebrafish model is advantageous for this assessment because its embryos remain transparent. The 3D spatial localization of fluorescence-labeled cardiac cells in and around the heart using light-sheet technology revealed dislocalization of the heart from the outflow tract in two-day-old zebrafish embryos treated with 50 μM and 100 μM VPA (P < 0.01) and those embryos exposed to 20 μM VPA presented hypoplastic distal ventricles (P < 0.01). These two observed phenotypes are second heart field-derived cardiac defects. Quantitative analysis of the light-sheet imaging demonstrated that folic acid (FA) supplementation significantly increased the numbers of endocardial and myocardial cells (P < 0.05) and the accretion of second heart field-derived cardiomyocytes to the arterial pole of the outflow tract. The heart rate increased in response to the cellular changes occurring in embryonic heart development (P < 0.05). The present study disclosed the cellular mechanism underlying the role of FA in spontaneous cellular changes in cardiogenesis and in VPA-associated cardiotoxicity. The 3D light-sheet assay may be the next-generation test to evaluate the risks of previously undetected pharmaceutical and environmental cardiotoxicities in both humans and animals.
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Affiliation(s)
- Seoyoung Ki
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea
| | - Seung-Hae Kwon
- Korea Basic Science Institute Chuncheon Center, Chuncheon, South Korea
| | - Juneyong Eum
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea
| | - Ahmed A Raslan
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea
| | - Kil-Nam Kim
- Korea Basic Science Institute Chuncheon Center, Chuncheon, South Korea
| | - Byung Joon Hwang
- Department of Molecular Bioscience, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea.
| | - Yun Kee
- Division of Biomedical Convergence, College of Biomedical Science, Kangwon National University, Chuncheon, South Korea.
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Scheller K, Kalmring F, Scheller C, Schubert J, Bialek J. Oral vitamin B1-substitution does not decrease genetically determined cleft rate in mice (A/WySn). J Craniomaxillofac Surg 2017; 45:1948-1954. [PMID: 29037922 DOI: 10.1016/j.jcms.2017.05.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/10/2017] [Accepted: 05/30/2017] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Cleft lip and palate (CL/P) are one of the most common human birth defects. Animal experiments and clinical investigations show a clear reduction of teratogenic clefts by a high-dose vitamin B supplementation during early pregnancy, especially in families at risk (reduction of recurrence). The aim of this work was to examine the influence of thiamine (vitamin B1) on CL/P appearance in genetically determined A/WySn mice within different supplementation starting points. MATERIALS AND METHODS A total of 24 A/WySn female mice were orally supplemented with high doses (80 mg/kg) of thiamine at different times of pregnancy (5 groups, n = 90). The influence of thiamine on the abortion rate and CL/P appearance in the offspring was analyzed with respect to the concentration of thiamine in the serum and amniotic fluid (HPLC-chromatography). Immunochemical analyses of the ThTr-1 und ThTr-2 receptor-status were performed in midface sections of A/WySn-fetuses and the corresponding placenta, with and without CL/P. RESULTS High doses of orally supplemented thiamine did not reduce the CL/P appearance in A/WySn mice. However, the different starting points of vitamin B1 substitution had some influence. Additionally, an obvious decrease in aborted fetuses was noticed in all supplemented groups. The oral substitution caused a clear increase of the serum concentration in all mothers, but showed no increase of the amniotic fluid concentration. Then immunohistochemistry detected an overexpression of ThTr-1 in the midface and an irregular localization of ThTr-2 in the placenta of fetuses with clefts. CONCLUSION Our results suggest a time-dependent influence of thiamine on CL/P appearance in female mice. The prophylactic/periconceptional, but not the therapeutic supplementation, starting point can be proposed as a crucial step for regular facial and palatal fusion in embryonic development. The absolute rate of CL/P was not reduced, and the concentration of the water-soluble thiamine could not increase in the amniotic fluid. Thus the proposed local effect of thiamine failed in the development of genetically determined mice.
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Affiliation(s)
- Konstanze Scheller
- Department of Oral and Maxillofacial and Facial Plastic Surgery, Martin-Luther-University Halle-Wittenberg (Head: Prof. Dr. Dr. A.W. Eckert), Ernst-Grube-Straße 40, 06120 Halle, Germany.
| | - Florian Kalmring
- Department of Oral and Maxillofacial and Facial Plastic Surgery, Martin-Luther-University Halle-Wittenberg (Head: Prof. Dr. Dr. A.W. Eckert), Ernst-Grube-Straße 40, 06120 Halle, Germany
| | - Christian Scheller
- Department of Neurosurgery, Martin-Luther-University Halle-Wittenberg (Head: Prof. Dr. C. Strauss), Ernst-Grube-Straße 40, 06120 Halle, Germany
| | | | - Joanna Bialek
- Department of Human Genetics, Martin-Luther-University Halle-Wittenberg (Head: Prof. Dr. K. Hoffmann), Magdeburger Straße 2, 06112 Halle, Germany
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13
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Lewis CW, Jacob LS, Lehmann CU, Krol D, Gereige R, Karp J, Fisher-Owens S, Braun P, Jacob L, Segura A. The Primary Care Pediatrician and the Care of Children With Cleft Lip and/or Cleft Palate. Pediatrics 2017; 139:peds.2017-0628. [PMID: 28557774 DOI: 10.1542/peds.2017-0628] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Orofacial clefts, specifically cleft lip and/or cleft palate (CL/P), are among the most common congenital anomalies. CL/P vary in their location and severity and comprise 3 overarching groups: cleft lip (CL), cleft lip with cleft palate (CLP), and cleft palate alone (CP). CL/P may be associated with one of many syndromes that could further complicate a child's needs. Care of patients with CL/P spans prenatal diagnosis into adulthood. The appropriate timing and order of specific cleft-related care are important factors for optimizing outcomes; however, care should be individualized to meet the specific needs of each patient and family. Children with CL/P should receive their specialty cleft-related care from a multidisciplinary cleft or craniofacial team with sufficient patient and surgical volume to promote successful outcomes. The primary care pediatrician at the child's medical home has an essential role in making a timely diagnosis and referral; providing ongoing health care maintenance, anticipatory guidance, and acute care; and functioning as an advocate for the patient and a liaison between the family and the craniofacial/cleft team. This document provides background on CL/P and multidisciplinary team care, information about typical timing and order of cleft-related care, and recommendations for cleft/craniofacial teams and primary care pediatricians in the care of children with CL/P.
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Affiliation(s)
- Charlotte W. Lewis
- Division of General Pediatrics and Hospital Medicine, Department of Pediatrics, University of Washington School of Medicine and Seattle Children’s Hospital, Seattle, Washington
| | - Lisa S. Jacob
- Georgetown Pediatric Dentistry and Orthodontics, Georgetown, Texas; and
| | - Christoph U. Lehmann
- Departments of Biomedical Informatics and Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
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Tettamanti L, Avantaggiato A, Nardone M, Palmieri A, Tagliabue A. New insights in orofacial cleft: epidemiological and genetic studies on italian samples. ACTA ACUST UNITED AC 2017; 10:11-19. [PMID: 28757931 DOI: 10.11138/orl/2017.10.1.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cleft of the lip and/or palate (CL±P) is the most common congenital craniofacial anomaly affecting around 1 in 700 live births worldwide. Clefts of the human face can be classified anatomically as cleft lip only (CL), cleft palate only (CP), cleft lip and palate (CLP) or a combined group of cleft lip with or without cleft palate (CL±P), based on differences in embryologic development. CL±P has a genetic base and several linkage and association analyses have been performed in order to obtain important information about the role of candidate genes in its onset; not less important are gene-environment interactions that play an increasing role in its aetiology. In CL±P, several loci have been seen associated with the malformation, and, in some cases, a specific gene mapping in a locus has also been identified as susceptibility factor. In CP, one gene has been found, but many more are probably involved. In this short review the genetic studies carried out on CL±P, and the interaction with environmental factors (alcohol, smoking, drugs) are discussed.
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Affiliation(s)
- L Tettamanti
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - A Avantaggiato
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - M Nardone
- Ministry of Public Health, Rome, Italy
| | - A Palmieri
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - A Tagliabue
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
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