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Does Maternal Cigarette Smoking During Pregnancy Cause Cleft Lip and Palate in Offspring?
Muin J. Khoury, MD, PhD;
Marco Gomez-Farias, MD, MPH;
Joseph Mulinare, MD, MSPH
Am J Dis Child. 1989;143(3):333-337.
Abstract
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• To investigate the relationship between maternal cigarette smoking and the risk of oral clefts in offspring, we examined data from the Atlanta Birth Defects Case-Control Study, which included 238 cases of cleft lip with or without cleft palate and 107 cases of cleft palate ascertained by the Metropolitan Atlanta Congenital Defects Program from 1968 through 1980. In all, 2809 infants who served as controls were frequency matched to cases by race, period of birth, and hospital of birth. Maternal periconceptional exposures to smoking were investigated through use of a structured questionnaire. Smoking exposure was defined as reported maternal smoking during the periconceptional period (from 3 months before conception to 3 months after pregnancy began). Offspring of smoking mothers were 1.6 and 2.0 times more likely than offspring of nonsmoking mothers to have isolated cleft lip with or without cleft palate and cleft palate, respectively. On the other hand, offspring of smoking mothers were not at increased risk of having cleft palate or cleft lip with or without cleft palate that are associated with other defects. Adjustment for potential confounding variables did not alter these results. A relatively modest effect of smoking may be explained by the presence of underlying etiologic heterogenity in oral clefts and differential susceptibility to smoking. Because of the inconsistencies in the literature on the relationship between smoking and oral clefts, these results suggest the need to refine oral clefts into more homogeneous subgroups in epidemiologic studies of these defects.
(AJDC. 1989;143:333-337)
Author Affiliations
From the Birth Defects and Genetic Diseases Branch, Division of Birth Defects and Developmental Disabilities, Center for Environmental Health and Injury Control, Centers for Disease Control, Public Health Service, US Department of Health and Human Services (Drs Khoury and Mulinare), and the Department of Community Health, Emory University School of Medicine (Dr Gomez-Farias), Atlanta, Ga
Footnotes
Accepted for publication November 19, 1988.
Reprint requests to Centers for Disease Control, Division of Birth Defects and Developmental Disabilities, Atlanta, GA 30333 (Dr Khoury).
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