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The Correlation between Maternal Exposure to Air Pollution and the Risk of Orofacial Clefts in Infants: a Systematic Review and Meta-Analysis.

Rao A, Ahmed MK, Taub PJ, Mamoun JS - J Oral Maxillofac Res (2016)

Bottom Line: Odds ratios were extracted from the eight studies and tabulated in this meta-analysis.Quality analysis showed six high quality, one medium quality, and one low quality study.NOx was consistently associated with decreased risk of cleft lip with or without palate and cleft palate.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Vascular Surgery, Mount Sinai Cleft & Craniofacial Center, Icahn School of Medicine at Mount Sinai, New York USA.

ABSTRACT

Objectives: The authors performed a systematic review and meta-analysis to investigate the possible correlation between ambient air pollution and orofacial cleft anomalies in newborns.

Material and methods: A literature search was performed using the PubMed and Google Scholar, using the keywords "air pollution", "cleft lip", "cleft palate", "carbon monoxide", "ozone", "sulfur dioxide", "nitrogen oxide", "nitrogen dioxide", and "aerodynamic diameter". Eight epidemiologic articles met the criteria of correlating either carbon monoxide (CO), ozone (O3), nitrogen oxides (NOx), airborne particulate matter of less than 10 µm in diameter (PM10), or sulfur dioxide (SO2) exposures with clefting of the palate alone, clefting of the lip alone, or clefting of the lip and palate. Odds ratios were extracted from the eight studies and tabulated in this meta-analysis. Quality analysis showed six high quality, one medium quality, and one low quality study.

Results: Meta-analysis of the combined data confirmed the association of O3 exposure and risk of orofacial cleft anomalies (OR = 1.08; P = 0.02). NOx was consistently associated with decreased risk of cleft lip with or without palate and cleft palate.

Conclusions: Ozone showed the strongest correlation with cleft lip and cleft palate anomalies. However, the studies overall showed an inconsistent correlation between orofacial clefts and air pollutants.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of the search result and study selection.
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fig1: Flow diagram of the search result and study selection.

Mentions: Figure 1 shows a flow diagram of the search result and study selection. Eight articles were identified [12,17-23] that met the inclusion criteria (Table 1). Most studies were judged to be of medium or high quality. Most studies used comprehensive statistical analysis, methods, and appropriate case selection with detailed inclusion and exclusion criteria. The studies, performed in the United States, Asia, England or Australia, used large retrospective birth cohorts obtained from government birth registries, to identify a large study population of several hundred thousand people, counted the total cases of cleft anomalies (ranging from 69 to 888 among the articles), then obtained from the larger population a randomly chosen sub-population of controls that was multiple times the number of cleft cases, to obtain adequate statistical power. These studies generally used air pollutant data obtained from large networks of fixed site monitoring stations, and generally used a time period of 1 to 3 months after conception when measuring air pollutant levels, since the risk of orofacial cleft formation is highest during this period post-conception [24,25]. Most of the reviewed articles were case-control studies and measured several air pollutants, and reported an odds ratio for the development of orofacial cleft anomalies for different quartiles of air pollutant concentration.


The Correlation between Maternal Exposure to Air Pollution and the Risk of Orofacial Clefts in Infants: a Systematic Review and Meta-Analysis.

Rao A, Ahmed MK, Taub PJ, Mamoun JS - J Oral Maxillofac Res (2016)

Flow diagram of the search result and study selection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4837606&req=5

fig1: Flow diagram of the search result and study selection.
Mentions: Figure 1 shows a flow diagram of the search result and study selection. Eight articles were identified [12,17-23] that met the inclusion criteria (Table 1). Most studies were judged to be of medium or high quality. Most studies used comprehensive statistical analysis, methods, and appropriate case selection with detailed inclusion and exclusion criteria. The studies, performed in the United States, Asia, England or Australia, used large retrospective birth cohorts obtained from government birth registries, to identify a large study population of several hundred thousand people, counted the total cases of cleft anomalies (ranging from 69 to 888 among the articles), then obtained from the larger population a randomly chosen sub-population of controls that was multiple times the number of cleft cases, to obtain adequate statistical power. These studies generally used air pollutant data obtained from large networks of fixed site monitoring stations, and generally used a time period of 1 to 3 months after conception when measuring air pollutant levels, since the risk of orofacial cleft formation is highest during this period post-conception [24,25]. Most of the reviewed articles were case-control studies and measured several air pollutants, and reported an odds ratio for the development of orofacial cleft anomalies for different quartiles of air pollutant concentration.

Bottom Line: Odds ratios were extracted from the eight studies and tabulated in this meta-analysis.Quality analysis showed six high quality, one medium quality, and one low quality study.NOx was consistently associated with decreased risk of cleft lip with or without palate and cleft palate.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Vascular Surgery, Mount Sinai Cleft & Craniofacial Center, Icahn School of Medicine at Mount Sinai, New York USA.

ABSTRACT

Objectives: The authors performed a systematic review and meta-analysis to investigate the possible correlation between ambient air pollution and orofacial cleft anomalies in newborns.

Material and methods: A literature search was performed using the PubMed and Google Scholar, using the keywords "air pollution", "cleft lip", "cleft palate", "carbon monoxide", "ozone", "sulfur dioxide", "nitrogen oxide", "nitrogen dioxide", and "aerodynamic diameter". Eight epidemiologic articles met the criteria of correlating either carbon monoxide (CO), ozone (O3), nitrogen oxides (NOx), airborne particulate matter of less than 10 µm in diameter (PM10), or sulfur dioxide (SO2) exposures with clefting of the palate alone, clefting of the lip alone, or clefting of the lip and palate. Odds ratios were extracted from the eight studies and tabulated in this meta-analysis. Quality analysis showed six high quality, one medium quality, and one low quality study.

Results: Meta-analysis of the combined data confirmed the association of O3 exposure and risk of orofacial cleft anomalies (OR = 1.08; P = 0.02). NOx was consistently associated with decreased risk of cleft lip with or without palate and cleft palate.

Conclusions: Ozone showed the strongest correlation with cleft lip and cleft palate anomalies. However, the studies overall showed an inconsistent correlation between orofacial clefts and air pollutants.

No MeSH data available.


Related in: MedlinePlus