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  • Title: Maternal underweight and obesity and risk of orofacial clefts in a large international consortium of population-based studies.
    Author: Kutbi H, Wehby GL, Moreno Uribe LM, Romitti PA, Carmichael S, Shaw GM, Olshan AF, DeRoo L, Rasmussen SA, Murray JC, Wilcox A, Lie RT, Munger RG.
    Journal: Int J Epidemiol; 2017 Feb 01; 46(1):190-199. PubMed ID: 27215617.
    Abstract:
    BACKGROUND: Evidence on association of maternal pre-pregnancy weight with risk of orofacial clefts is inconsistent. METHODS: Six large case-control studies of orofacial clefts from Northern Europe and the USA were included in analyses pooling individual-level data. Cases included 4943 mothers of children with orofacial clefts (cleft lip only: 1135, cleft palate with cleft lip: 2081, cleft palate only: 1727) and controls included 10 592 mothers of unaffected children. Association of orofacial cleft risk with pre-pregnancy maternal weight classified by level of body mass index (BMI, kg/m 2 ) was evaluated using logistic regression adjusting for multiple covariates. RESULTS: Cleft palate, both alone and with cleft lip (CP+/-CL), was associated with maternal class II+ pre-pregnancy obesity (≥ 35)compared with normal weight [adjusted odds ratio (aOR) = 1.36; 95% confidence interval (CI) = 1.16, 1.58]. CP+/-CL was marginally associated with maternal underweight (aOR = 1.16; 95% CI = 0.98, 1.36). Cleft lip alone was not associated with BMI. CONCLUSIONS: In this largest population-based study to date, we found an increased risk of cleft palate, with or without cleft lip, in class II+ obese mothers compared with normal-weight mothers; underweight mothers may also have an increased risk, but this requires further study. These results also suggest that extremes of weight may have a specific effect on palatal development.
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