Limits...
Passive smoking in the etiology of non-syndromic orofacial clefts: a systematic review and meta-analysis.

Sabbagh HJ, Hassan MH, Innes NP, Elkodary HM, Little J, Mossey PA - PLoS ONE (2015)

Bottom Line: Studies have found a consistent positive association between maternal smoking and non-syndromic orofacial clefts (NSOFC).Egger's test was used to test for small study effects.In the studies that provided data enabling crude and adjusted odd ratios to be compared, adjustment for potential confounders attenuated the magnitude of association to about a 1.5-fold increase in risk.

View Article: PubMed Central - PubMed

Affiliation: Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Oral Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom.

ABSTRACT

Background: Studies have found a consistent positive association between maternal smoking and non-syndromic orofacial clefts (NSOFC). However, no comprehensive assessment of the association between NSOFC and passive smoking has been undertaken. This systematic review and meta-analysis explores the relationship between maternal passive smoking and NSOFC, and compares the associations between passive and active smoking.

Methods and findings: Search strategy, inclusion / exclusion criteria, and data extraction from studies reporting maternal passive smoking and NSOFC was implemented without language restrictions. Risks of bias in the identified studies were assessed and this information was used in sensitivity analyses to explain heterogeneity. Meta-analysis and meta-regression of the extracted data were performed. Egger's test was used to test for small study effects. Fourteen eligible articles were identified. Maternal passive smoking exposure was associated with a twofold increase in risk of NSOFC (odds ratio: 2.11, 95% confidence interval: 1.54-2.89); this was apparent for both cleft lip with and without palate (OR: 2.05, 95% CI: 1.27-3.3) and cleft palate (OR: 2.11, 95% CI: 1.23-3.62). There was substantial heterogeneity between studies. In the studies that provided data enabling crude and adjusted odd ratios to be compared, adjustment for potential confounders attenuated the magnitude of association to about a 1.5-fold increase in risk.

Conclusion: Overall, maternal passive smoking exposure results in a 1.5 fold increase in risk of NSOFC, similar to the magnitude of risk reported for active smoking, but there is marked heterogeneity between studies. This heterogeneity is not explained by differences in the distribution of cleft types, adjustment for covariates, broad geographic region, or study bias/quality. This thorough meta-analysis provides further evidence to minimize exposure to environmental tobacco smoke in policy making fora and in health promotion initiatives.

Show MeSH

Related in: MedlinePlus

Forest plot for meta-analysis of the association between NSOFC phenotype (CL/P and CP) and maternal passive smoking.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4356514&req=5

pone.0116963.g006: Forest plot for meta-analysis of the association between NSOFC phenotype (CL/P and CP) and maternal passive smoking.

Mentions: Fig. 6 shows the relationship between passive smoking and the different types of NSOFC; CL/P and CP. The risk of having an infant with either CL/P or CP associated with passive smoking was approximately doubled (for CL/P OR: 2.05, 95% CI: 1.27 to 3.3; for CP OR: 2.11, 95% CI: 1.23 to 3.62).


Passive smoking in the etiology of non-syndromic orofacial clefts: a systematic review and meta-analysis.

Sabbagh HJ, Hassan MH, Innes NP, Elkodary HM, Little J, Mossey PA - PLoS ONE (2015)

Forest plot for meta-analysis of the association between NSOFC phenotype (CL/P and CP) and maternal passive smoking.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356514&req=5

pone.0116963.g006: Forest plot for meta-analysis of the association between NSOFC phenotype (CL/P and CP) and maternal passive smoking.
Mentions: Fig. 6 shows the relationship between passive smoking and the different types of NSOFC; CL/P and CP. The risk of having an infant with either CL/P or CP associated with passive smoking was approximately doubled (for CL/P OR: 2.05, 95% CI: 1.27 to 3.3; for CP OR: 2.11, 95% CI: 1.23 to 3.62).

Bottom Line: Studies have found a consistent positive association between maternal smoking and non-syndromic orofacial clefts (NSOFC).Egger's test was used to test for small study effects.In the studies that provided data enabling crude and adjusted odd ratios to be compared, adjustment for potential confounders attenuated the magnitude of association to about a 1.5-fold increase in risk.

View Article: PubMed Central - PubMed

Affiliation: Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Oral Health Sciences, University of Dundee, Dundee, Scotland, United Kingdom.

ABSTRACT

Background: Studies have found a consistent positive association between maternal smoking and non-syndromic orofacial clefts (NSOFC). However, no comprehensive assessment of the association between NSOFC and passive smoking has been undertaken. This systematic review and meta-analysis explores the relationship between maternal passive smoking and NSOFC, and compares the associations between passive and active smoking.

Methods and findings: Search strategy, inclusion / exclusion criteria, and data extraction from studies reporting maternal passive smoking and NSOFC was implemented without language restrictions. Risks of bias in the identified studies were assessed and this information was used in sensitivity analyses to explain heterogeneity. Meta-analysis and meta-regression of the extracted data were performed. Egger's test was used to test for small study effects. Fourteen eligible articles were identified. Maternal passive smoking exposure was associated with a twofold increase in risk of NSOFC (odds ratio: 2.11, 95% confidence interval: 1.54-2.89); this was apparent for both cleft lip with and without palate (OR: 2.05, 95% CI: 1.27-3.3) and cleft palate (OR: 2.11, 95% CI: 1.23-3.62). There was substantial heterogeneity between studies. In the studies that provided data enabling crude and adjusted odd ratios to be compared, adjustment for potential confounders attenuated the magnitude of association to about a 1.5-fold increase in risk.

Conclusion: Overall, maternal passive smoking exposure results in a 1.5 fold increase in risk of NSOFC, similar to the magnitude of risk reported for active smoking, but there is marked heterogeneity between studies. This heterogeneity is not explained by differences in the distribution of cleft types, adjustment for covariates, broad geographic region, or study bias/quality. This thorough meta-analysis provides further evidence to minimize exposure to environmental tobacco smoke in policy making fora and in health promotion initiatives.

Show MeSH
Related in: MedlinePlus