Prenatal and perinatal factors associated with isolated oral clefting.
OBJECTIVE
To describe medical service utilization and maternal morbid conditions of women who carry offspring with oral clefts (OCs), to describe maternal and offspring complications during birth, and to evaluate postnatal characteristics of their newborns with isolated OCs.


METHODS
Two thousand four hundred thirty-seven patients with isolated OCs and 4871 unaffected matched controls meeting inclusion criteria were selected from the U.S. Natality database for 1997. Matching variables were mother's and father's race and child's race, sex, county of birth, and month of birth. Patients and controls were compared in terms of maternal demographic characteristics, gestational complications, physical characteristics of the newborns, maternal exposure to potential risk factors, and adequacy of prenatal care.


RESULTS
Although the quality of care was very good in both groups, low gestational age, low birth weight, and low 5-minute Apgar score are more frequent among newborns with OCs than in unaffected controls. Mothers of offspring with OCs are at increased risk, compared with mothers of controls, of having hydramnios or oligohydramnios, eclampsia, and abruptio placenta. Obstetric procedures, such as amniocentesis, electronic fetal monitoring, induction of labor, tocolysis, and ultrasound, and repeat cesarean deliveries are more frequent among mothers of patients than those of controls. At birth, newborns with isolated OCs are at risk of having hyaline membrane disease and of requiring assisted ventilation, independently of gestational age.


CONCLUSIONS
The results of this large population-based, case-control study suggest that the presence of an OC in the offspring is associated with increased risk for prenatal and perinatal complications in the mother.
Wyszynski
Diego F
DF
Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA. dfw@bu.edu
Wu
Tianxia
T
D000037:Abruptio Placentae / Q000150:complications; D000328:Adult; D000649:Amniocentesis; D001034:Apgar Score; D016022:Case-Control Studies; D017604:Cesarean Section, Repeat; D016009:Chi-Square Distribution; D002971:Cleft Lip / Q000150:complications*; D002972:Cleft Palate / Q000150:complications*; D016001:Confidence Intervals; D004461:Eclampsia / Q000150:complications; D005260:Female; D005315:Fetal Diseases / Q000503:physiopathology*; D005323:Fetal Monitoring; D005865:Gestational Age; D006801:Humans; D006819:Hyaline Membrane Disease / Q000150:complications; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007751:Labor, Induced; D016015:Logistic Models; D008297:Male; D008423:Maternal Age; D018811:Maternal Exposure; D007744:Obstetric Labor Complications / Q000503:physiopathology; D016017:Odds Ratio; D006831:Polyhydramnios / Q000150:complications; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D012121:Respiration, Artificial; D016216:Ultrasonography, Prenatal