Association of Parental Environmental Exposures and Supplementation Intake with Risk of Nonsyndromic Orofacial Clefts: A Case-Control Study in Heilongjiang Province, China
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design and Participant Selection
2.2. Data Collection
2.3. Statistical Analysis
3. Results
3.1. Social-Economic Characteristics of the Participants
Characteristics | Control n = 480 (%) | n = 362 (%) | CL/P OR (95%CI) | p-Adjusted | n = 137 (%) | CPO OR (95%CI) | p-Adjusted |
---|---|---|---|---|---|---|---|
Maternal gestational age | <0.001 | <0.001 | |||||
<20 | 8 (1.67%) | 16 (4.4%) | 1.85 (0.77–4.43) | 8 (5.8%) | 2.79 (1.00–7.75) | ||
20–24 | 173 (36.0%) | 187 (51.7%) | Ref. | 62 (45.3%) | Ref. | ||
25–29 | 229 (47.7%) | 85 (23.5%) | 0.34 (0.25–0.48) | 36 (26.3%) | 0.44 (0.28–0.69) | ||
30–34 | 58 (12.1%) | 39 (10.8%) | 0.62 (0.39–0.98) | 22 (16.1%) | 1.06 (0.60–1.87) | ||
≥35 | 12 (2.5%) | 35 (9.6%) | 2.70 (1.36–5.37) | 9 (6.5%) | 2.09 (0.84–5.21) | ||
Maternal education | <0.001 | <0.001 | |||||
Primary or junior high school | 172 (35.8%) | 319 (88.1%) | 8.04 (5.42–11.92) | 110 (80.3%) | 4.70 (2.86–7.72) | ||
High school or technical school | 169 (35.2%) | 39 (10.8%) | Ref. | 23 (16.8%) | Ref. | ||
University or higher | 139 (29.0%) | 4 (1.1%) | 0.13 (0.04–0.36) | 4 (2.9%) | 0.21 (0.07–0.63) | ||
Paternal education | <0.001 | <0.001 | |||||
Primary or junior high school | 161 (33.5%) | 315 (87.0%) | 9.03 (6.08–13.40) | 111 (81.0%) | 8.27 (4.63–14.78) | ||
High school or technical school | 180 (37.5%) | 39 (10.8%) | Ref. | 15 (10.9%) | Ref. | ||
University or higher | 139 (29.0%) | 8 (2.2%) | 0.27 (0.12–0.59) | 11 (8.1%) | 0.95 (0.42–2.13) | ||
Household annual income | <0.001 | <0.001 | |||||
<¥10,000 | 100 (20.8%) | 173 (47.8%) | 1.94 (1.39–2.70) | 58 (42.3%) | 1.90 (1.21–2.98) | ||
¥10,000–30,000 | 167 (34.8%) | 149 (41.2%) | Ref. | 51 (37.2%) | Ref. | ||
≥¥30,000 | 213 (44.4%) | 40 (11.0%) | 0.21 (0.14–0.32) | 28 (20.5%) | 0.43 (0.26–0.71) | ||
Gender of infant | <0.001 | 0.002 | |||||
Male | 245 (51.0%) | 250 (69.1%) | Ref. | 49 (35.8%) | Ref. | ||
Female | 235 (49.0%) | 112 (30.9%) | 0.47 (0.35–0.62) | 88 (64.2%) | 1.87 (1.26–2.77) | ||
Gravidity | <0.001 | <0.001 | |||||
1 | 309 (64.4%) | 164 (45.3%) | Ref. | 59 (43.1%) | Ref. | ||
2 | 116 (24.2%) | 115 (31.8%) | 1.87 (1.36–2.57) | 47 (34.3%) | 2.12 (1.37–3.29) | ||
≥3 | 55 (11.4%) | 83 (22.9%) | 2.84 (1.93–4.20) | 31 (22.6%) | 2.95 (1.95–4.97) | ||
Negative reproductive history a | 0.002 | <0.001 | |||||
no | 345 (71.9%) | 223 (61.6%) | Ref. | 74 (54.0%) | Ref. | ||
yes | 135 (28.1%) | 139 (38.4%) | 1.59 (1.91–2.13) | 63 (46.0%) | 2.18 (1.47–3.22) | ||
Body mass index (kg/m2) | 0.004 | 0.555 | |||||
<18 | 58 (12.1%) | 62 (17.1%) | 1.64 (1.11–2.42) | 23 (16.8%) | 1.46 (0.86–2.49) | ||
18–24 | 384 (80%) | 251 (69.3%) | Ref. | 104 (75.9%) | Ref. | ||
25–29 | 31 (6.5%) | 42 (11.6%) | 2.07 (1.27–3.39) | 8 (5.8%) | 0.95 (0.43–2.14) | ||
≥30 | 7 (1.4%) | 7 (2.0%) | 1.54 (0.53–4.41) | 2 (1.5%) | 1.06 (0.22–5.15) |
Factors | Control n = 480 (%) | CL/P n = 362 (%) | p-Adjusted | OR (95%CI) | CPO n = 137 (%) | p-Adjusted | OR (95%CI) |
---|---|---|---|---|---|---|---|
Maternal illness | |||||||
History of fever | 46 (9.6%) | 79 (21.8%) | <0.001 | 2.63 (1.78, 3.90) | 27 (19.7%) | 0.004 | 2.32 (1.38, 3.89) |
Cold without fever | 36 (7.5%) | 120 (33.1%) | <0.001 | 6.06 (4.05, 9.09) | 48 (35.0%) | <0.001 | 6.65 (4.08, 10.84) |
History of skin disease | 3 (0.6%) | 15 (4.1%) | 0.005 | 6.87 (1.97, 23.92) | 4 (2.9%) | 0.050 | 4.78 (1.06, 21.63) |
Medication use | |||||||
Antipyretics or analgesic a | 13 (2.7%) | 34 (9.4%) | <0.001 | 3.72 (1.93, 7.16) | 15 (10.9%) | <0.001 | 4.42 (2.05, 9.53) |
Anti-infectious drugs b | 20 (4.2%) | 74 (20.4%) | <0.001 | 5.91 (3.93, 9.90) | 30 (21.9%) | <0.001 | 6.45 (3.53, 11.79) |
Topical corticosteroids | 2 (0.4%) | 12 (3.3%) | 0.008 | 8.19 (1.82, 36.82) | 3 (2.2%) | 0.092 | 5.35 (0.88, 32.34) |
Lifestyle factors | |||||||
Maternal smoking | 28 (5.8%) | 26 (7.2%) | 0.452 | 1.25 (0.72, 2.17) | 9 (6.6%) | 0.750 | 1.14 (0.52, 2.47) |
Paternal smoking | 197 (41.0%) | 218 (60.2%) | <0.001 | 2.17 (1.65, 2.87) | 82 (59.9%) | <0.001 | 2.14 (1.45, 3.15) |
Maternal passive smoking | 175 (36.5%) | 214 (59.1%) | <0.001 | 2.52 (1.90, 3.33) | 71 (51.8%) | 0.002 | 1.87 (1.28, 2.75) |
Maternal alcohol consumption | 72 (15.0%) | 43 (11.9%) | 0.177 | 0.75 (0.50, 1.12) | 26 (19.0%) | 0.376 | 1.28 (0.77, 2.11) |
Paternal alcohol consumption | 74 (15.4%) | 170 (47.0%) | <0.001 | 4.86 (3.52, 6.70) | 66 (48.2%) | <0.001 | 5.02 (3.31, 7.63) |
Maternal negative life events | 32 (27.5%) | 179 (49.4%) | <0.001 | 2.56 (1.92, 3.42) | 69 (50.4%) | <0.001 | 2.66 (1.81, 3.90) |
Maternal occupational exposure | |||||||
Organic solvents | 8 (1.7%) | 22 (6.1%) | 0.002 | 3.82 (1.68, 8.67) | 16 (11.7%) | <0.001 | 7.80 (3.26, 18.66) |
Heavy metals | 7 (1.5%) | 34 (9.4%) | <0.001 | 7.00 (3.07, 15.99) | 12 (8.8%) | <0.001 | 6.48 (2.50, 16.81) |
Pesticides | 5 (1.0%) | 73 (20.2%) | <0.001 | 23.99 (9.58, 60.06) | 21 (15.3%) | <0.001 | 17.20 (6.35, 46.60) |
Supplementation | Control n = 480 (%) | n = 362 (%) | CL/P p-Adjusted | OR (95%CI) | n = 137 (%) | CPO p-Adjusted | OR (95%CI) |
---|---|---|---|---|---|---|---|
Folic acid | |||||||
Any use during preconception period a | 30 (6.3%) | 10 (2.8%) | 0.025 | 0.43 (0.21, 0.88) | 6 (4.4%) | 0.431 | 0.69 (0.28, 1.69) |
Any use during first trimester | 97 (24.9%) | 67 (18.5%) | 0.590 | 0.91 (0.64, 1.29) | 34 (24.9%) | 0.257 | 1.32 (0.84, 2.07) |
Multivitamins | |||||||
Any use during preconception period a | 106 (28.3%) | 4 (1.1%) | <0.001 | 0.04 (0.01, 0.11) | 3 (2.2%) | <0.001 | 0.08 (0.02, 0.25) |
Any use during first trimester | 85 (17.7%) | 47 (13.0%) | 0.070 | 0.69 (0.47, 1.02) | 15 (10.9%) | 0.084 | 0.57 (0.32, 1.03) |
Cod liver oil | |||||||
Any use during preconception period a | 30 (6.3%) | 1 (0.3%) | 0.002 | 0.04 (0.01, 0.31) | 1 (0.7%) | 0.048 | 0.11 (0.01, 0.82) |
Any use during first trimester | 21 (4.4%) | 2 (0.6%) | 0.006 | 0.12 (0.03, 0.52) | 1 (0.7%) | 0.099 | 0.16 (0.02, 1.21) |
3.2. Multivariable Analysis
Factors | Control n = 480 (%) | CL/P n = 362 (%) | aOR (95%CI) | CPO n = 137 (%) | aOR (95%CI) |
---|---|---|---|---|---|
History of fever | 46 (9.6%) | 79 (21.8%) | 3.11 (1.67, 5.82) | 27 (19.7%) | 3.31 (1.58, 6.94) |
Common cold without fever | 36 (7.5%) | 120 (33.1%) | 5.56 (2.96, 10.47) | 48 (35.0%) | 8.23 (4.08, 16.59) |
History of skin disease | 3 (0.6%) | 15 (4.1%) | 12.07 (1.81, 80.50) | 4 (2.9%) | - |
Paternal smoking | 197 (41.0%) | 218 (60.2%) | 2.15 (1.37, 3.38) | 82 (59.9%) | 1.82 (1.06, 3.13) |
Paternal alcohol consumption | 74 (15.4%) | 170 (47.0%) | 5.04 (3.00, 8.46) | 66 (48.2%) | 4.40 (2.50, 7.74) |
Maternal negative life events | 32 (27.5%) | 179 (49.4%) | 1.67 (1.95, 2.67) | 69 (50.4%) | - |
Organic solvents | 8 (1.7%) | 22 (6.1%) | 6.07 (1.49, 24.76) | 16 (11.7%) | 10.65 (2.54, 44.67) |
Heavy metals | 7 (1.5%) | 34 (9.4%) | 5.67 (1.34, 24.09) | 12 (8.8%) | 7.28 (1.41, 37.63) |
Pesticides | 5 (1.0%) | 73 (20.2%) | 5.97 (2.10, 16.98) | 21 (15.3%) | 3.48 (1.06, 11.46) |
Any multivitamin use during preconception period | 106 (28.3%) | 4 (1.1%) | 0.06 (0.02, 0.23) | 3 (2.2%) | 0.06 (0.01, 0.30) |
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Hao, Y.; Tian, S.; Jiao, X.; Mi, N.; Zhang, B.; Song, T.; An, L.; Zheng, X.; Zhuang, D. Association of Parental Environmental Exposures and Supplementation Intake with Risk of Nonsyndromic Orofacial Clefts: A Case-Control Study in Heilongjiang Province, China. Nutrients 2015, 7, 7172-7184. https://doi.org/10.3390/nu7095328
Hao Y, Tian S, Jiao X, Mi N, Zhang B, Song T, An L, Zheng X, Zhuang D. Association of Parental Environmental Exposures and Supplementation Intake with Risk of Nonsyndromic Orofacial Clefts: A Case-Control Study in Heilongjiang Province, China. Nutrients. 2015; 7(9):7172-7184. https://doi.org/10.3390/nu7095328
Chicago/Turabian StyleHao, Yanru, Subao Tian, Xiaohui Jiao, Na Mi, Bing Zhang, Tao Song, Le An, Xudong Zheng, and Deshu Zhuang. 2015. "Association of Parental Environmental Exposures and Supplementation Intake with Risk of Nonsyndromic Orofacial Clefts: A Case-Control Study in Heilongjiang Province, China" Nutrients 7, no. 9: 7172-7184. https://doi.org/10.3390/nu7095328