Objective
To assess the association between maternal active cigarette smoking and the risk of
oral clefts in the offspring.
Study Design
Oral clefts are divided into three subgroups: total clefts, cleft lip with or without
cleft palate (CL ± P), and cleft palate only (CP). Data from studies on different
levels of smoking were gathered to examine the dose–response effect.
Results
The present meta-analysis included 29 case-control and cohort studies through Cochrane,
PubMed, and Ovid Medline searches. A modest but statistically significant association
was found between maternal active smoking and CL ± P (odds ratio [OR] 1.368; 95% confidence
interval [CI] 1.259-1.486) as well as CP (OR 1.241; 95% CI 1.117-1.378). Half the
studies showed positive dose–response effect for each subgroup (test for linear trend,
P < .05).
Conclusions
There is a moderate risk for having a child with a CL ± P or CP in women who smoke
during pregnancy. We could not confirm whether there was a positive dose–response
effect between maternal smoking and clefts.
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Article info
Publication history
Published online: August 18, 2016
Accepted:
August 8,
2016
Received in revised form:
March 20,
2016
Received:
January 3,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
