Risk of orofacial clefts in relation to maternal body mass index, diabetes and hypertension

Article type: Research Article

Authors: Da Silva, A.M.^{a; d} | De Lavôr, J.R.^{b; d} | Freitas, V.S.^c | Vieira, A.R.^{d; *}

Affiliations: [a] Public Health PhD Graduate Program, State University of Feira de Santana, Feira de Santana, BA, Brazil | [b] Pediatric Dentistry PhD Graduate Program, State University of Pernambuco, Recife, PE, Brazil | [c] Department of Health, State University of Feira de Santana, Feira de Santana, BA, Brazil | [d] Department of Oral and Craniofacial Sciences, University of Pittsburgh, Pittsburgh, PA, USA

Correspondence: [*] Address for correspondence: Alexandre Rezende Vieira, 412 Salk Pavilion, Pittsburgh, PA, USA. Tel.: +1 412 383 8972; E-mail: arv11@pitt.edu.

Abstract: BACKGROUND: To investigate if maternal body mass index, diabetes and hypertension are associated with orofacial clefts. METHODS: Case-control study. Information from 53,188 live births with and without orofacial cleft registered at USA Vital Statistics Natality Birth Data between 2017 and 2021. Case group consisted of all affected live births diagnosed with orofacial clefts (13,297 cases). Comparison group consisted of 39,891 live births without clefts or any other congenital malformation. Information about orofacial cleft cases were compared with the comparison group. The unadjusted and adjusted Odds Ratios were estimated to evaluate the strength of association between mother’s pre-pregnancy body mass index, maternal diabetes and hypertension and orofacial cleft occurrence, assuming a p value < 0.05 and 95% confidence intervals (95% C.I.) for statistically significant differences. RESULTS: Mother’s pre-pregnancy body mass index, maternal diabetes and maternal hypertension are conditions associated with an increased risk of orofacial cleft development in the child (OR = 1.08, p = 0.004, 95% C.I. = 1.024–1.149; OR = 1.32, 95%, p = 0.000, 95% C.I. = 1.202–1.444; and OR = 1.35, p = 0.000, 95% C.I. = 1.239–1.484; respectively). Maternal ethnicity, sex of infant, and cigarette smoking pregnancy remained as covariates after adjustments in all logistic regression models. CONCLUSION: Due to the increased prevalence of obesity, diabetes, and hypertension, and also to their association with congenital malformations, such as clefts, it is recommended that mothers planning to become pregnant to follow healthy habits, maintain healthy weight, and be screened for possible diabetes or hypertension prior to conception and early in pregnancy.

Keywords: Body mass index, cleft lip, cleft palate, diabetes complications, hypertension

DOI: 10.3233/NPM-230118

Journal: Journal of Neonatal-Perinatal Medicine, vol. 17, no. 1, pp. 41-48, 2024