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  • Title: Family history and socioeconomic risk factors for non-syndromic cleft lip and palate: a matched case-control study in a less developed country.
    Author: Acuña-González G, Medina-Solís CE, Maupomé G, Escoffie-Ramírez M, Hernández-Romano J, Márquez-Corona Mde L, Islas-Márquez AJ, Villalobos-Rodelo JJ.
    Journal: Biomedica; 2011; 31(3):381-91. PubMed ID: 22674314.
    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.
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