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  • Title: Cigarette smoking as an etiologic factor in cleft lip and palate.
    Author: Ericson A, Källén B, Westerholm P.
    Journal: Am J Obstet Gynecol; 1979 Oct 01; 135(3):348-51. PubMed ID: 484624.
    Abstract:
    A case-control study has been made on smoking habits in women who, during 1975, gave birth to infants with closure defects of the central nervous system (ASB) or with cleft lip or cleft palate (CLP). For each case, two control subjects with nonmalformed infants were selected and matched for delivery unit, time of delivery, maternal age, and maternal parity. Smoking habits were routinely included in hospital records at first visit to a maternity health clinic during pregnancy. Data were studied for 66 cases of CLP, 66 cases of ASB, and 261 control subjects. Significantly more women who had infants with CLP smoked than did control women, but women with ASB infants showed a normal smoking pattern. Drug use did not explain the findings. It is suggested that maternal smoking is one of many factors of importance in the etiology of cleft lip and cleft palate in humans. In Sweden a case control study was made on smoking habits in women who, during 1975, gave birth to infants with closure defects of the central nervous system (ASB) or with cleft lip or cleft palate (CLP). In each case 2 malformed infants were selected and matched for delivery unit, maternal age, maternal parity, and time of delivery. Smoking habits were routinely included in hospital records at first visit to a maternity health clinic during pregnancy. 66 cases of closure defects and 66 cases of cleft palate were compared to 261 control subjects. More women who had infants with cleft palate smoked than did control women, but women with ASB infants showed a normal smoking pattern. Drug use did not explain the findings. Maternal smoking is one of many factors in the etiology of cleft lip and cleft palate in humans. 41 of the 58 women with CLP infants smoked. If this is an overestimate of the actual frequency of smoking women in this group, there is a 95% probability that the rate is at least 57% (binomial distribution). If a 45% smoking rate among women who have nonmalformed infants is reasonably accurate, approximately 22% of the infants born in Sweden with CLP are malformed due to maternal smoking. There is no other known exogenous cause of human malformations in the environment.
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