Periconceptional nutrient intakes and risks of orofacial clefts in California

Pediatr Res. 2013 Oct;74(4):457-65. doi: 10.1038/pr.2013.115. Epub 2013 Jul 3.


Background: Evidence indicates that maternal nutrient intake may play a role in the development of birth defects. We investigated the association of maternal periconceptional intake of vitamin supplements and dietary nutrients with risk of developing cleft palate (CP) and cleft lip with or without cleft palate (CLP).

Methods: Data were from a population-based, case-control study of fetuses and liveborn infants delivered in California in 1999-2003. Analyses included 170 cases with CP, 425 with CLP, and 534 nonmalformed controls. Dietary intake was estimated from a food frequency questionnaire.

Results: Vitamin supplement intake was associated with a modestly decreased risk of clefts, but the confidence intervals (CIs) include 1.0. Among women who did not use vitamin supplements, dietary intake of several micronutrients was associated with risk of clefts. We found at least a twofold elevated risk of CP with low intake of riboflavin, magnesium, calcium, vitamin B12, and zinc; all CIs excluded 1.0. For CLP, we found at least a twofold elevated risk with low intake of niacin, riboflavin, vitamin B12, and calcium, and a decreased risk with high intake of folate and cryptoxanthin; all CIs excluded 1.0.

Conclusion: The results suggest that periconceptional nutrient intake may be associated with risk of CP and CLP.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • California / epidemiology
  • Case-Control Studies
  • Cleft Lip / epidemiology*
  • Cleft Lip / prevention & control
  • Cleft Palate / epidemiology*
  • Cleft Palate / prevention & control
  • Dietary Supplements*
  • Female
  • Humans
  • Maternal Nutritional Physiological Phenomena / physiology*
  • Surveys and Questionnaires
  • Vitamins / pharmacology*


  • Vitamins