OBJECTIVE: To investigate the association between pregnancy planning and orofacial clefts in the United Kingdom. DESIGN: Case-control study. SETTING: Scotland and the Manchester and Merseyside regions of England. PARTICIPANTS: One hundred and ninety-one children born with nonsyndromic orofacial cleft, 1997 to 2000, and 247 controls. MAIN OUTCOME MEASURE: Cleft lip with and without cleft palate, and cleft palate. RESULTS: There was an inverse association between planning for pregnancy and orofacial cleft in the offspring (odds ratio [OR] = 0.51, 95% confidence interval [CI] = 0.33-0.79). An unplanned pregnancy together with smoking in the first trimester of pregnancy resulted in almost treble the risk of a child with an orofacial cleft when compared with those who planned their pregnancy and did not smoke (OR = 2.92, CI = 1.50-5.65). CONCLUSIONS: Planned pregnancies were associated with a lower risk of orofacial clefts. Isolation of the elements of pregnancy planning implicated in these results is difficult. Current preconception advice needs to reach a wider audience; however, for maximum impact, efforts are needed to reduce the numbers of unplanned pregnancies.
OBJECTIVE: To investigate the association between pregnancy planning and orofacial clefts in the United Kingdom. DESIGN: Case-control study. SETTING: Scotland and the Manchester and Merseyside regions of England. PARTICIPANTS: One hundred and ninety-one children born with nonsyndromic orofacial cleft, 1997 to 2000, and 247 controls. MAIN OUTCOME MEASURE: Cleft lip with and without cleft palate, and cleft palate. RESULTS: There was an inverse association between planning for pregnancy and orofacial cleft in the offspring (odds ratio [OR] = 0.51, 95% confidence interval [CI] = 0.33-0.79). An unplanned pregnancy together with smoking in the first trimester of pregnancy resulted in almost treble the risk of a child with an orofacial cleft when compared with those who planned their pregnancy and did not smoke (OR = 2.92, CI = 1.50-5.65). CONCLUSIONS: Planned pregnancies were associated with a lower risk of orofacial clefts. Isolation of the elements of pregnancy planning implicated in these results is difficult. Current preconception advice needs to reach a wider audience; however, for maximum impact, efforts are needed to reduce the numbers of unplanned pregnancies.
Authors: Laura T Arbour; Kris Beking; Nhu D Le; Pamela A Ratner; John J Spinelli; Kay Teschke; Richard P Gallagher; Zenaida U Abanto; Helen Dimich-Ward Journal: Can J Public Health Date: 2010 May-Jun