title: The relationship between maternal corticosteroid use and orofacial clefts-a meta-analysis.
abstract: The aim was to evaluate the relationship between maternal corticosteroid use during first trimester of pregnancy and risk of orofacial clefts (OC). The overall findings showed a certain association between maternal corticosteroid use and occurrence of OC, compared with non-users (OR=1.16 [95% CI: 1.01-1.33]). When study type was considered this association was significant only for case-control studies (OR=1.22 [95% CI: 1.02-1.47]), and not for cohort studies (OR=1.09 [95% CI: 0.88-1.34]) when there are many confounders (dose, route of application, disease etc.) and biases (re-call, loss-to follow-up etc.) that still need to be considered. A subgroup analysis based on the type of OC gave an overall OR of 1.41 (95% CI: 1.14-1.74) in the case-control studies for cleft lip with or without palate (CL/P) and 1.09 (95% CI: 0.80-1.48) for cleft palate only (CPO), when comparing maternal corticosteroid users with non-users. However, for cohort studies, the overall OR for CL/P is 1.06 (95% CI: 0.82-1.37) and 1.20 (95% CI: 0.83-1.75) for CPO. The absolute risk of facial cleft after prenatal exposure to corticosteroids, if any, is small.
authors.affiliation: Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; The Key Laboratory of Oral Clinical Medicine of Shandong Province, The Affiliated Hospital of Qingdao University, Qingdao 266003, China. Electronic address: wenlinxiao@sina.com.
authors.forename: Wen-Lin
authors.initials: WL
authors.lastname: Xiao
authors.affiliation: Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; The Key Laboratory of Oral Clinical Medicine of Shandong Province, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
authors.forename: Xiao-Ya
authors.initials: XY
authors.lastname: Liu
authors.affiliation: Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; The Key Laboratory of Oral Clinical Medicine of Shandong Province, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
authors.forename: Yan-Shan
authors.initials: YS
authors.lastname: Liu
authors.affiliation: Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; The Key Laboratory of Oral Clinical Medicine of Shandong Province, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
authors.forename: Dai-Zun
authors.initials: DZ
authors.lastname: Zhang
authors.affiliation: Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao 266003, China; The Key Laboratory of Oral Clinical Medicine of Shandong Province, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
authors.forename: Ling-Fa
authors.initials: LF
authors.lastname: Xue
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002971:Cleft Lip / Q000453:epidemiology*; D002972:Cleft Palate / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011261:Pregnancy Trimester, First
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Corticosteroids; Meta-analysis; Orofacial clefts