title: Neighborhood-Based Socioeconomic Position and Risk of Oral Clefts Among Offspring.
abstract: OBJECTIVE
  We determined the association between maternal neighborhood socioeconomic position (SEP) and the risk of cleft lip with or without cleft palate (CL±P) or cleft palate alone (CP) in offspring.
  
  
  METHODS
  We obtained information on CL±P (n = 2555) and CP (n = 1112) cases and unaffected controls (n = 14 735) among infants delivered during 1999 to 2008 from the Texas Birth Defects Registry. Neighborhood SEP variables, drawn from the 2000 US Census, included census tract-level poverty, education, unemployment, occupation, housing, and crowding, from which we created a composite neighborhood deprivation index (NDI). We used mixed-effects logistic regression to evaluate neighborhood SEP and oral clefts.
  
  
  RESULTS
  Mothers with CL±P-affected offspring were more likely to live in high-NDI (adverse) areas than mothers with unaffected offspring (odds ratio [OR] = 1.20, 95% confidence interval [CI] = 1.05, 1.37). This association was strongest among Hispanic mothers (OR = 1.32, 95% CI = 1.07, 1.62). No associations were observed with CP.
  
  
  CONCLUSIONS
  Using data from one of the world's largest active surveillance birth defects registries, we found that adverse neighborhood SEP is modestly associated with CL±P, especially among Hispanics. These findings may have important implications for health disparities prevention.
authors.affiliation: Philip J. Lupo and Heather E. Danysh are with the Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX. Elaine Symanski is with the Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston. Peter H. Langlois is with the Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin. Yi Cai and Michael D. Swartz are with the Division of Biostatistics, University of Texas School of Public Health.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Lupo
authors.affiliation: Philip J. Lupo and Heather E. Danysh are with the Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX. Elaine Symanski is with the Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston. Peter H. Langlois is with the Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin. Yi Cai and Michael D. Swartz are with the Division of Biostatistics, University of Texas School of Public Health.
authors.forename: Heather E
authors.initials: HE
authors.lastname: Danysh
authors.affiliation: Philip J. Lupo and Heather E. Danysh are with the Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX. Elaine Symanski is with the Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston. Peter H. Langlois is with the Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin. Yi Cai and Michael D. Swartz are with the Division of Biostatistics, University of Texas School of Public Health.
authors.forename: Elaine
authors.initials: E
authors.lastname: Symanski
authors.affiliation: Philip J. Lupo and Heather E. Danysh are with the Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX. Elaine Symanski is with the Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston. Peter H. Langlois is with the Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin. Yi Cai and Michael D. Swartz are with the Division of Biostatistics, University of Texas School of Public Health.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Langlois
authors.affiliation: Philip J. Lupo and Heather E. Danysh are with the Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX. Elaine Symanski is with the Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston. Peter H. Langlois is with the Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin. Yi Cai and Michael D. Swartz are with the Division of Biostatistics, University of Texas School of Public Health.
authors.forename: Yi
authors.initials: Y
authors.lastname: Cai
authors.affiliation: Philip J. Lupo and Heather E. Danysh are with the Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX. Elaine Symanski is with the Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, Houston. Peter H. Langlois is with the Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin. Yi Cai and Michael D. Swartz are with the Division of Biostatistics, University of Texas School of Public Health.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Swartz
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002971:Cleft Lip / Q000453:epidemiology / Q000209:etiology*; D002972:Cleft Palate / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011203:Poverty / Q000706:statistics & numerical data; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000209:etiology; D012042:Registries; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013781:Texas / Q000453:epidemiology; D055815:Young Adult