Parental health and social support in the first trimester of pregnancy and the risk of oral clefts: a questionnaire-based, case-control study

Plast Reconstr Surg. 2015 Jan;135(1):212-218. doi: 10.1097/PRS.0000000000000778.


Background: Nonsyndromic oral clefts are complex in cause and have multiple genetic and environmental risk factors. This retrospective, questionnaire-based, case-control study investigated the relationship between oral clefts and parental mental and physical health and social support.

Methods: Three hundred forty-seven parents of children with nonsyndromic oral clefts and 420 controls were included. Maternal and paternal health during the first trimester was assessed using interviews and questionnaires modeled from the Cornell Medical Index and the Social Support Rating Scale. Case-control analyses were performed using t tests, chi-square tests, and logistic regression.

Results: Parental age, household income, and subsisting on farming were significantly different for cases and controls. The Cornell Medical Index for cases was significantly worse compared with controls for physical and psychological health. Logistic regression showed that nine factors were significantly associated with oral clefts: paternal respiratory health (OR, 1.56; p = 0.03), maternal gastrointestinal health (OR, 1.71; p < 0.01), maternal musculoskeletal health (OR, 1.50; p < 0.01), paternal nervous system health (OR, 2.82; p < 0.01), maternal frequency of illness (OR, 2.21; p = 0.01), maternal diseases (OR, 2.44; p < 0.01), maternal health habits (OR, 1.73; p < 0.01), paternal feelings of inadequacy (OR, 2.28; p = 0.03), and maternal anger (OR, 2.28; p < 0.01) in the first trimester. Weaker social support from the community was associated with oral clefts (p < 0.01).

Conclusion: Maternal and paternal health and social support may affect a family's risk of having a child with a cleft.

Clinical question/level of evidence: Risk, III.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Cleft Palate / epidemiology*
  • Family Health
  • Female
  • Health Status*
  • Humans
  • Infant, Newborn
  • Male
  • Mental Health*
  • Middle Aged
  • Parents
  • Pregnancy
  • Pregnancy Trimester, First
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Social Support*
  • Surveys and Questionnaires*
  • Young Adult