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Family history and socioeconomic risk factors for non-syndromic cleft lip and palate: A matched case-control study in a less developed country.

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Title: Family history and socioeconomic risk factors for non-syndromic cleft lip and palate: A matched case-control study in a less developed country.
Alternate Title: Factores de riesgo hereditarios y socioeconómicos para labio o paladar hendido no asociados a un síndrome en México: estudio de casos y controles pareado.
Authors: Acuña-González, Gladys1,2, Medina-Solís, Carlo E.3 cemedinas@yahoo.com, Maupomé, Gerardo4,5, Escoffie-Ramírez, Mauricio6, Hernández-Romano, Jesús7, Márquez-Corona, María de L.3, Islas-Márquez, Arturo J.3, Villalobos-Rodelo, Juan J.8
Source: Biomédica: Revista del Instituto Nacional de Salud. sep2011, Vol. 31 Issue 3, p381-391. 11p. 5 Charts.
Subjects: EPIDEMIOLOGY, CLEFT palate, PALATE abnormalities, DISEASE risk factors, SOCIOECONOMIC factors
Abstract (English): Introduction. From an epidemiological point of view, non-syndromic orofacial clefts are the mos common oral congenital deformities worldwide. Objective. Family histories were traced and socioeconomic risk factors were identified for non syndromic cleft lip with or without cleft palate. Material and methods. A case-control study was carried out with 208 cases of non-syndromic cleft lip with or without cleft palate, and matched by age and sex with 416 controls. Cases were patients attendin a referral clinic from 2002 through 2004 in Campeche, Mexico. A questionnaire was administered t collect sociodemographic and socioeconomic variables as well as familial background relevant to non-syndromic cleft lip with or without cleft palate. Conditional logistic regression models were used; adjusted odds ratios and 95% confidence intervals were calculated. Results. In the multivariate model, the following risk factors were identified: 1) low socioeconomi status; 2) birth in the southern region of Campeche state; 3) home delivery or delivery in a publicl funded hospital; 4) occurrence of prior non-syndromic cleft lip with or without cleft palate cases in the father's or mother's family: 5) having a sibling with non-syndromic cleft lip with or without cleft palate 6) the proband having another malformation, and 7) a history of infections during pregnancy. Prenat care consisting of vitamin supplementation was a protective factor for non-syndromic cleft lip with o without cleft palate (odds ratio=0.29). Conclusions. A "social gradient in health" was seen to link oral malformation with diet components, and several socioeconomic and socio-demographic factors broadly encompassed in low socioeconomi status. Further characterization of risk factors will guide the assemblage of a pro-active counseling an prevention program for families at risk for non-syndromic cleft lip and cleft palate. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción. Desde el punto de vista epidemiológico, las hendiduras faciales son las deformidades orales más comunes alrededor del mundo. Objetivo. Identificar los factores de riesgo hereditarios y socioeconómicos relacionados con la presencia de labio o paladar hendido no asociados a un síndrome. Materiales y métodos. Se hizo un estudio de casos y controles en el que se incluyeron 208 casos con diagnóstico de labio, paladar hendido o ambos no asociados a un síndrome, los cuales fueron pareados por edad y sexo con 416 controles. Se incluyeron todos los pacientes quirúrgicos atendidos durante el periodo 2002-2004 en el programa estatal de labio o paladar hendido de Campeche, México. Se aplicó un cuestionario en el que se recogió información sobre variables sociodemográficas y socioeconómicas, así como sobre antecedentes hereditarios de labio o paladar hendido no asociados a un síndrome en la familia. Debido a que el diseño fue pareado, el análisis se hizo con regresión logística condicionada. Resultados. En el modelo multivariado para labio o paladar hendido no asociado a un síndrome se identificaron de forma significativa (p<0.05) los siguientes factores de riesgo: nivel socioeconómico bajo (razón de momios, RM=2.02), nacimiento en el sur del estado (RM=3.96), nacimiento en casa (RM=2.51) o nacimiento en hospital público (RM=4.08), antecedentes heredofamiliares paternos (RM=5.38), antecedentes heredofamiliares maternos (RM=4.11), tener otro hijo con labio o paladar hendido en la familia (RM=46.02), presentar algún otro defecto congénito asociado (RM=8.20) e infeccióón en el embarazo (RM=2.90), y como factor protector, el cuidado prenatal y el uso de vitaminas (RM=0.29). Conclusiones. El mayor riesgo en nuestra muestra para labio, paladar hendido o ambos, no asociados a un síndrome, radica en las variables relacionadas con los antecedentes familiares y hereditarios, y las indicadoras de la posición socioeconómica. Se observó un efecto protector del manejo prenatal con vitaminas. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Introduction. From an epidemiological point of view, non-syndromic orofacial clefts are the mos common oral congenital deformities worldwide. Objective. Family histories were traced and socioeconomic risk factors were identified for non syndromic cleft lip with or without cleft palate. Material and methods. A case-control study was carried out with 208 cases of non-syndromic cleft lip with or without cleft palate, and matched by age and sex with 416 controls. Cases were patients attendin a referral clinic from 2002 through 2004 in Campeche, Mexico. A questionnaire was administered t collect sociodemographic and socioeconomic variables as well as familial background relevant to non-syndromic cleft lip with or without cleft palate. Conditional logistic regression models were used; adjusted odds ratios and 95% confidence intervals were calculated. Results. In the multivariate model, the following risk factors were identified: 1) low socioeconomi status; 2) birth in the southern region of Campeche state; 3) home delivery or delivery in a publicl funded hospital; 4) occurrence of prior non-syndromic cleft lip with or without cleft palate cases in the father's or mother's family: 5) having a sibling with non-syndromic cleft lip with or without cleft palate 6) the proband having another malformation, and 7) a history of infections during pregnancy. Prenat care consisting of vitamin supplementation was a protective factor for non-syndromic cleft lip with o without cleft palate (odds ratio=0.29). Conclusions. A "social gradient in health" was seen to link oral malformation with diet components, and several socioeconomic and socio-demographic factors broadly encompassed in low socioeconomi status. Further characterization of risk factors will guide the assemblage of a pro-active counseling an prevention program for families at risk for non-syndromic cleft lip and cleft palate. [ABSTRACT FROM AUTHOR]
ISSN:01204157