Analysis of Environmental Exposures for Nonsyndromic Cleft Lip and/or Palate: A Case-Control Study

Karim  Ahmed Sakran; Bassam  Mutahar Abotaleb; Remsh  Khaled Al-Rokhami; Tsung-yen  Hsieh; Mohammed Ali  Al-Wesabi; Abdo Ahmed  Mohammed; Hesham Mohammed Al-Sharani; Ping  Shi; Dengqi  He

doi:10.18502/ijph.v51i3.8934

Karim Ahmed Sakran Department of Oral and Maxillofacial Surgery, The First Hospital of Lanzhou University, Lanzhou, China
Bassam Mutahar Abotaleb Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Remsh Khaled Al-Rokhami Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou, China
Tsung-yen Hsieh Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Medi-cal Center, Cincinnati, Ohio, USA
Mohammed Ali Al-Wesabi Department of Oral Medicine and Periodontology, Faculty of Dentistry, University of Science and Technology, Sana’a, Yemen
Abdo Ahmed Mohammed Department of Oral and Maxillofacial Surgery, The First Hospital of Lanzhou University, Lanzhou, China
Hesham Mohammed Al-Sharani Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
Ping Shi Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
Dengqi He Department of Oral and Maxillofacial Surgery, The First Hospital of Lanzhou University, Lanzhou, China

DOI: https://doi.org/10.18502/ijph.v51i3.8934

Keywords: Nonsyndromic cleft lip; Etiology; Risk factors; Case-control study; Logistic regression analysis

Abstract

Background: Orofacial cleft is among the most common developmental malformations in humans. This study aimed to identify the relationship between environmental factors and nonsyndromic cleft lip and/or palate (NSCL/P) in Northwest China.

Methods: This case-control study was conducted in Gansu Province, China over two years (Jan. 1, 2017–Jan. 1, 2019). Overall, 600 NSCL/P cases and 660 normal control cases were finally enrolled in the current study. Data were collected by conducting face-to-face interviews with both parents of each case.

Results: Univariate (χ²) analysis revealed 22 factors as being significantly associated with NSCL/P. Multivariate (stepwise logistic regression) analysis identified that 14 factors had statistically significant association with NSCL/P. Male gender (OR=0.789), paternal age at childbirth of 25-29 yr (OR=0.690), and folic acid supplement (OR=0.197) were found to be protective factors against NSCL/P. On the other hand, blood A-type, multiple births, positive family history of NSCLP (OR=6.660), parental consanguinity (OR=6.107), positive abortion history, high or low maternal childbearing age, and maternal passive smoking (OR=4.349), malnutrition (OR=4.431), infections, and drug use (OR=2.188) during early gestation were significant risk factors for NSCL/P.

Conclusion: Parental age at childbirth of 25–29 yr, and folic acid supplement can reduce the risk of NSCL/P. By contrast, maternal passive smoking, infections, and drug use during early gestation period, and multiple births, parental consanguinity, positive family history, and maternal abortion history can increase the risk of NSCL/P. Identification of risk factors is essential in minimizing the incidence of NSCL/P in a particular population.