title: Impact and risk factors of craniofacial malformations in a Colombian population.
abstract: OBJECTIVE
  Craniofacial malformations comprise diverse diagnoses, implying a wide range of morbidity and disability among populations. Our aim was to study them as a group and describe their epidemiological factors inside a population as well as finding common risk factors for their presentation in Colombia.
  
  
  METHODS
  We conducted a case-control study in several Colombian hospitals participating in the ECLAMC (Spanish acronym for Latin-American Collaborative Study of Congenital Malformations) program. For the analysis we included 374 cases of isolated malformations and 728 controls, out of 44,701 births.
  
  
  RESULTS
  A rate of 83.67 cases per 10,000 births was found for craniofacial malformations as a group, with an overall sex ratio of 1. We found predominance for their presentation on the right side. As main associations we obtained a positive family history of another craniofacial malformation (OR: 3.10 CI 95% [2.24-4.30]), particularly preauricular tags (OR 52.36 CI 95% [12.62-217.16]), preauricular pits (OR: 36.35 CI 95% [4.82-274.27]) and cleft lip with or without palate (OR: 2.50 CI 95% [1.07-5.84]). Medication use during pregnancy was also linked to malformations (OR: 2.00 CI 95% [1.38-2.89]). Specific agents such as ferrous sulfate (OR: 1.46 CI 95% [1.13-1.89]), folic acid (OR: 1.35 CI 95% [1.02-1.79]) and nifedipine (OR: 2.88 CI 95% [1.22-6.79]) also showed a significant correlation. Maternal alcohol use was also identified as a possible risk factor (OR: 2.45 CI 95% [1.39-4.29]).
  
  
  CONCLUSIONS
  Craniofacial malformations are frequently encountered among the group of congenital defects. When they present in an isolated fashion, familial history is an important risk factor, although some prenatal factors such as alcohol and some medications may have influence over their prevalence.
authors.affiliation: Instituto de Genética Humana, Pontificia Universidad Javeriana, Carrera 7 No 40-62, Edificio 32, Bogotá, Colombia. izarante@javeriana.edu.co
authors.forename: Ignacio
authors.initials: I
authors.lastname: Zarante
authors.forename: María Andrea
authors.initials: MA
authors.lastname: López
authors.forename: Andrés
authors.initials: A
authors.lastname: Caro
authors.forename: Juan Camilo
authors.initials: JC
authors.lastname: García-Reyes
authors.forename: Juan Camilo
authors.initials: JC
authors.lastname: Ospina
mesh_terms: D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003105:Colombia / Q000453:epidemiology; D016001:Confidence Intervals; D019465:Craniofacial Abnormalities / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution