title: Maternal alcohol binge-drinking in the first trimester and the risk of orofacial clefts in offspring: a large population-based pooling study.
abstract: Using individual participant data from six population-based case-control studies, we conducted pooled analyses to examine maternal alcohol consumption and the risk of clefts among >4600 infants with cleft lip only, cleft lip with cleft palate, or cleft palate only and >10,000 unaffected controls. We examined two first-trimester alcohol measures: average number of drinks/sitting and maximum number of drinks/sitting, with five studies contributing to each analysis. Study-specific odds ratios (ORs) were estimated using logistic regression and pooled to generate adjusted summary ORs. Across studies, 0.9-3.2 % of control mothers reported drinking an average of 5+ drinks/sitting, while 1.4-23.5 % reported drinking a maximum of 5+ drinks/sitting. Compared with non-drinkers, mothers who drank an average of 5+ drinks/sitting were more likely to deliver an infant with cleft lip only (pooled OR 1.48; 95 % confidence intervals 1.01, 2.18). The estimate was higher among women who drank at this level 3+ times (pooled OR 1.95; 1.23, 3.11). Ever drinking a maximum of 5+ drinks/sitting and non-binge drinking were not associated with cleft risk. Repeated heavy maternal alcohol consumption was associated with an increased risk of cleft lip only in offspring. There was little evidence of increased risk for other cleft types or alcohol measures.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Postboks 7804, 5020, Bergen, Norway. Lisa.De.Roo@igs.uib.no.|Epidemiology Branch, National Institute of Environmental Health Sciences/NIH, Durham, NC, USA. Lisa.De.Roo@igs.uib.no.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: DeRoo
authors.affiliation: Epidemiology Branch, National Institute of Environmental Health Sciences/NIH, Durham, NC, USA.
authors.forename: Allen J
authors.initials: AJ
authors.lastname: Wilcox
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Postboks 7804, 5020, Bergen, Norway.|Norwegian Institute of Public Health, Medical Birth Registry of Norway, Bergen, Norway.
authors.forename: Rolv T
authors.initials: RT
authors.lastname: Lie
authors.affiliation: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Romitti
authors.affiliation: Epidemiology, Biostatistics and Biodemography, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Dorthe Almind
authors.initials: DA
authors.lastname: Pedersen
authors.affiliation: Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan, UT, USA.
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Munger
authors.affiliation: Department of Orthodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA.
authors.forename: Lina M
authors.initials: LM
authors.lastname: Moreno Uribe
authors.affiliation: Department of Health Management and Policy, The University of Iowa, 105 River Street, Iowa City, IA, 52242, USA. george-wehby@uiowa.edu.
authors.forename: George L
authors.initials: GL
authors.lastname: Wehby
mesh_terms: D000293:Adolescent; D000328:Adult; D063425:Binge Drinking / Q000150:complications* / Q000453:epidemiology; D002971:Cleft Lip / Q000209:etiology*; D002972:Cleft Palate / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000187:drug effects; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult
keywords: Alcohol; Cleft lip; Cleft palate