George L Wehby1, Lina M Moreno Uribe2, Allen J Wilcox3, Kaare Christensen4, Paul A Romitti5, Ronald G Munger6, Rolv T Lie7. 1. Department of Health Management and Policy, University of Iowa, Iowa City; Department of Economics, University of Iowa, Iowa City; Department of Preventive & Community Dentistry, University of Iowa, Iowa City; Public Policy Center, University of Iowa, Iowa City. Electronic address: george-wehby@uiowa.edu. 2. Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City. 3. National Institutes of Health, National Institute of Environmental Health Sciences, Epidemiology Branch, Durham, NC. 4. Department of Epidemiology, University of Southern Denmark, Odense, Denmark. 5. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City. 6. Center for Epidemiologic Studies, Utah State University, Logan; Department of Nutrition, Dietetics, and Food Sciences, Utah State University, Logan. 7. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Abstract
PURPOSE: To examine maternal smoking and body mass index (BMI) interactions in contributing to risk of oral clefts. METHODS: We studied 4935 cases and 10,557 controls from six population-based studies and estimated a pooled logistic regression of individual-level data, controlling for study fixed effects and individual-level risk factors. RESULTS: We found a significant negative smoking-BMI interaction, with cleft risk with smoking generally declining with higher BMI. For all clefts combined, the odds ratio for smoking was 1.61 (95% confidence interval [CI]: 1.39-1.86) at BMI 17 (underweight), 1.47 (95% CI: 1.34-1.62) at BMI 22 (normal weight), 1.35 (95% CI: 1.22-1.48) at BMI 27 (overweight), 1.21 (95% CI: 1.04-1.41) at BMI 33 (obese), and 1.13 (95% CI: 0.92-1.38) at BMI 37 (very obese). A negative interaction was also observed for isolated clefts and across cleft types but was more pronounced for cleft lip only and cleft palate only. CONCLUSIONS: Our findings suggest that the risk of oral clefts associated with maternal smoking is largest among underweight mothers, although the smoking-BMI interaction is strongest for cleft lip only and cleft palate only. BMI was not protective for the effects of smoking; a clinically relevant increase in smoking-related cleft risk was still present among heavier women.
PURPOSE: To examine maternal smoking and body mass index (BMI) interactions in contributing to risk of oral clefts. METHODS: We studied 4935 cases and 10,557 controls from six population-based studies and estimated a pooled logistic regression of individual-level data, controlling for study fixed effects and individual-level risk factors. RESULTS: We found a significant negative smoking-BMI interaction, with cleft risk with smoking generally declining with higher BMI. For all clefts combined, the odds ratio for smoking was 1.61 (95% confidence interval [CI]: 1.39-1.86) at BMI 17 (underweight), 1.47 (95% CI: 1.34-1.62) at BMI 22 (normal weight), 1.35 (95% CI: 1.22-1.48) at BMI 27 (overweight), 1.21 (95% CI: 1.04-1.41) at BMI 33 (obese), and 1.13 (95% CI: 0.92-1.38) at BMI 37 (very obese). A negative interaction was also observed for isolated clefts and across cleft types but was more pronounced for cleft lip only and cleft palate only. CONCLUSIONS: Our findings suggest that the risk of oral clefts associated with maternal smoking is largest among underweight mothers, although the smoking-BMI interaction is strongest for cleft lip only and cleft palate only. BMI was not protective for the effects of smoking; a clinically relevant increase in smoking-related cleft risk was still present among heavier women.
Authors: Juhua Luo; Kimberly Horn; Judith K Ockene; Michael S Simon; Marcia L Stefanick; Elisa Tong; Karen L Margolis Journal: Am J Epidemiol Date: 2011-08-29 Impact factor: 4.897
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Authors: A M Ditchfield; M Desforges; T A Mills; J D Glazier; M Wareing; K Mynett; C P Sibley; S L Greenwood Journal: Int J Obes (Lond) Date: 2014-12-30 Impact factor: 5.095
Authors: Lisa A DeRoo; Allen J Wilcox; Rolv T Lie; Paul A Romitti; Dorthe Almind Pedersen; Ronald G Munger; Lina M Moreno Uribe; George L Wehby Journal: Eur J Epidemiol Date: 2016-06-27 Impact factor: 8.082