Family history and socioeconomic risk factors for non-syndromic cleft lip and palate: a matched case-control study in a less developed country.
BACKGROUND
From an epidemiological point of view, non-syndromic orofacial clefts are the most common oral congenital deformities worldwide.


OBJECTIVE
Family histories were traced and socioeconomic risk factors were identified for non-syndromic cleft lip with or without cleft palate.


METHODS
A case-control study was carried out with 208 cases of non-syndromic cleft lip with or without cleft palate, and matched by age and sex with 416 controls. Cases were patients attending a referral clinic from 2002 through 2004 in Campeche, Mexico. A questionnaire was administered to collect sociodemographic and socioeconomic variables as well as familial background relevant to non-syndromic cleft lip with or without cleft palate. Conditional logistic regression models were used; adjusted odds ratios and 95% confidence intervals were calculated.


RESULTS
In the multivariate model, the following risk factors were identified: 1) low socioeconomic status; 2) birth in the southern region of Campeche state; 3) home delivery or delivery in a publicly funded hospital; 4) occurrence of prior non-syndromic cleft lip with or without cleft palate cases in the father's or mother's family: 5) having a sibling with non-syndromic cleft lip with or without cleft palate; 6) the proband having another malformation, and 7) a history of infections during pregnancy. Prenatal care consisting of vitamin supplementation was a protective factor for non-syndromic cleft lip with or without cleft palate (odds ratio=0.29).


CONCLUSIONS
A "social gradient in health" was seen to link oral malformation with diet components, and several socioeconomic and socio-demographic factors broadly encompassed in low socioeconomic status. Further characterization of risk factors will guide the assemblage of a pro-active counseling and prevention program for families at risk for non-syndromic cleft lip and cleft palate.
Facultad de Odontología, Universidad Autónoma de Campeche, Campeche, México.
Gladys
G
Acuña-González
Carlo E
CE
Medina-Solís
Gerardo
G
Maupomé
Mauricio
M
Escoffie-Ramírez
Jesús
J
Hernández-Romano
María de L
Mde L
Márquez-Corona
Arturo J
AJ
Islas-Márquez
Juan J
JJ
Villalobos-Rodelo
D001722:Birth Order; D016022:Case-Control Studies; D002648:Child; D002971:Cleft Lip / Q000453:epidemiology* / Q000235:genetics; D002972:Cleft Palate / Q000453:epidemiology* / Q000235:genetics; D016001:Confidence Intervals; D003906:Developing Countries; D005192:Family Health; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008800:Mexico / Q000453:epidemiology; D016017:Odds Ratio; D010290:Parents; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology; D011295:Prenatal Care; D017584:Reproductive History; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires