title: Neighborhood Deprivation and Risk of Congenital Heart Defects, Neural Tube Defects and Orofacial Clefts: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  We conducted this systematic review and meta-analysis to address the open question of a possible association between the socioeconomic level of the neighborhoods in which pregnant women live and the risk of Congenital Heart Defects (CHDs), Neural Tube Defects (NTDs) and OroFacial Clefts (OFCs).
  
  
  METHODS
  We searched MEDLINE from its inception to December 20th, 2015 for case-control, cohort and ecological studies assessing the association between neighborhood socioeconomic level and the risk of CHDs, NTDs and the specific phenotypes Cleft Lip with or without Cleft Palate (CLP) and Cleft Palate (CP). Study-specific risk estimates were pooled according to random-effect and fixed-effect models.
  
  
  RESULTS
  Out of 245 references, a total of seven case-control studies, two cohort studies and two ecological studies were assessed in the systematic review; all studies were enrolled in the meta-analysis with the exception of the two cohort studies. No significant association has been revealed between CHDs or NTDs and neighborhood deprivation index. For CLP phenotype subgroups, we found a significantly higher rate in deprived neighborhoods (Odds Ratios (OR) = 1.22, 95% CI: 1.10, 1.36) whereas this was not significant for CP phenotype subgroups (OR = 1.20, 95%CI: 0.89, 1.61).
  
  
  CONCLUSIONS
  In spite of the small number of epidemiological studies included in the present literature review, our findings suggest that neighborhood socioeconomic level where mothers live is associated only with an increased risk of CLP phenotype subgroups. This finding has methodological limitations that impede the formulation of firm conclusions, and further investigations should confirm this association.
authors: EHESP School of Public Health, Department of Environmental and Occupational Health, Rennes, Cedex 35043, France.|INSERM U1085 (IRSET), Department of Environmental and Occupational Health, Rennes, Cedex 35043, France.
authors: Séverine
authors: S
authors: Deguen
authors: EHESP School of Public Health, Department of Environmental and Occupational Health, Rennes, Cedex 35043, France.
authors: Wahida
authors: W
authors: Kihal
authors: EHESP School of Public Health, Department of Environmental and Occupational Health, Rennes, Cedex 35043, France.|INSERM U1085 (IRSET), Department of Environmental and Occupational Health, Rennes, Cedex 35043, France.
authors: Maxime
authors: M
authors: Jeanjean
authors: EHESP School of Public Health, Department of Environmental and Occupational Health, Rennes, Cedex 35043, France.
authors: Cindy
authors: C
authors: Padilla
authors: EHESP School of Public Health, Department of Environmental and Occupational Health, Rennes, Cedex 35043, France.|INSERM U1085 (IRSET), Department of Environmental and Occupational Health, Rennes, Cedex 35043, France.|Lorraine University Medical School, Nancy, Cedex 54052, France.
authors: Denis
authors: D
authors: Zmirou-Navier
mesh_terms: D016208:Databases, Factual; D005260:Female; D006330:Heart Defects, Congenital / Q000209:etiology*; D006801:Humans; D009056:Mouth Abnormalities / Q000209:etiology*; D009436:Neural Tube Defects / Q000209:etiology*; D016017:Odds Ratio; D011247:Pregnancy; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors