Maternal underweight and obesity and risk of orofacial clefts in a large international consortium of population-based studies
Maternal underweight and obesity and risk of orofacial clefts in a large international consortium of population-based studies
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DOI：
10.1093/ije/dyw035
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发表时间：
2017-02-01
影响因子：
7.7
通讯作者：
Munger, Ronald G.
中科院分区：
文献类型：
--
作者：
Kutbi, Hebah;Wehby, George L.;Munger, Ronald G.
背景资料：产妇孕前体重与orofacial clefts.Methods的风险关联的证据：6个大型病例对照研究的orofacial clefts从北方欧洲和美国被纳入分析汇总个人水平的数据。病例包括4943名口面裂儿童的母亲（仅唇裂：1135名，腭裂伴唇裂：2081名，仅腭裂：1727名），对照包括10592名未受影响儿童的母亲。按体重指数分类的孕前母亲体重与口面裂风险的关系结果：与正常体重相比，单独腭裂和合并唇裂（CP+/-CL）的母亲II级+孕前肥胖（>= 35）与母亲II级+孕前肥胖（>= 35）相关[校正比值比（aOR）= 1.36; 95%置信区间（CI）= 1.16，1.58]。CP+/-CL与母体体重不足轻微相关（aOR = 1.16; 95% CI = 0.98，1.36）。单独唇裂是不相关的BMI。结论：在这个最大的人口为基础的研究，到目前为止，我们发现一个风险增加腭裂，有或没有唇裂，在II类+肥胖的母亲与正常体重的母亲相比，体重不足的母亲也可能有风险增加，但这需要进一步的研究。这些结果还表明，极端的体重可能对腭发育有特定影响。
Background: Evidence on association of maternal pre-pregnancy weight with risk of orofacial clefts is inconsistent.Methods: Six large case-control studies of orofacial clefts from Northern Europe and the USA were included in analyses pooling individual-level data. Cases included 4943 mothers of children with orofacial clefts (cleft lip only: 1135, cleft palate with cleft lip: 2081, cleft palate only: 1727) and controls included 10 592 mothers of unaffected children. Association of orofacial cleft risk with pre-pregnancy maternal weight classified by level of body mass index (BMI, kg/m(2)) was evaluated using logistic regression adjusting for multiple covariates.Results: Cleft palate, both alone and with cleft lip (CP+/-CL), was associated with maternal class II+ pre-pregnancy obesity (>= 35) compared with normal weight [adjusted odds ratio (aOR) = 1.36; 95% confidence interval (CI) = 1.16, 1.58]. CP+/-CL was marginally associated with maternal underweight (aOR = 1.16; 95% CI = 0.98, 1.36). Cleft lip alone was not associated with BMI.Conclusions: In this largest population-based study to date, we found an increased risk of cleft palate, with or without cleft lip, in class II+ obese mothers compared with normal-weight mothers; underweight mothers may also have an increased risk, but this requires further study. These results also suggest that extremes of weight may have a specific effect on palatal development.