Family history and socioeconomic risk factors for non-syndromic cleft lip and palate: a matched case-control study in a less developed country

Biomedica. 2011 Jul-Sep;31(3):381-91. doi: 10.1590/S0120-41572011000300010.

Abstract

Introduction: From an epidemiological point of view, non-syndromic orofacial clefts are the most common oral congenital deformities worldwide.

Objective: Family histories were traced and socioeconomic risk factors were identified for non-syndromic cleft lip with or without cleft palate.

Material and methods: A case-control study was carried out with 208 cases of non-syndromic cleft lip with or without cleft palate, and matched by age and sex with 416 controls. Cases were patients attending a referral clinic from 2002 through 2004 in Campeche, Mexico. A questionnaire was administered to collect sociodemographic and socioeconomic variables as well as familial background relevant to non-syndromic cleft lip with or without cleft palate. Conditional logistic regression models were used; adjusted odds ratios and 95% confidence intervals were calculated.

Results: In the multivariate model, the following risk factors were identified: 1) low socioeconomic status; 2) birth in the southern region of Campeche state; 3) home delivery or delivery in a publicly funded hospital; 4) occurrence of prior non-syndromic cleft lip with or without cleft palate cases in the father's or mother's family: 5) having a sibling with non-syndromic cleft lip with or without cleft palate; 6) the proband having another malformation, and 7) a history of infections during pregnancy. Prenatal care consisting of vitamin supplementation was a protective factor for non-syndromic cleft lip with or without cleft palate (odds ratio=0.29).

Conclusions: A "social gradient in health" was seen to link oral malformation with diet components, and several socioeconomic and socio-demographic factors broadly encompassed in low socioeconomic status. Further characterization of risk factors will guide the assemblage of a pro-active counseling and prevention program for families at risk for non-syndromic cleft lip and cleft palate.

MeSH terms

  • Birth Order
  • Case-Control Studies
  • Child
  • Cleft Lip / epidemiology*
  • Cleft Lip / genetics
  • Cleft Palate / epidemiology*
  • Cleft Palate / genetics
  • Confidence Intervals
  • Developing Countries
  • Family Health*
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Mexico / epidemiology
  • Odds Ratio
  • Parents
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology
  • Prenatal Care
  • Reproductive History
  • Risk Factors
  • Socioeconomic Factors*
  • Surveys and Questionnaires