Maternal Cigarette Smoking and Cleft Lip and Palate: A Systematic Review and Meta-Analysis. (September 2022)

• Record Type: Journal Article
• Authors: Fell, Matthew; Dack, Kyle; Chummun, Shaheel; Sandy, Jonathan; Wren, Yvonne; Lewis, Sarah
• Is Part Of: Cleft palate-craniofacial journal. Volume 59:Number 9(2022)
• Page Start: 1185
• Page End: 1200
• Publication Date: 2022-09
• Subjects: cleft lip and palate -- cleft palate -- orofacial cleft -- pregnancy -- smoking; Cleft palate -- Periodicals; Skull -- Abnormalities -- Periodicals; Cranial manipulation -- Periodicals; Skull -- Abnormalities -- Surgery -- Periodicals; Face -- Abnormalities -- Surgery -- Periodicals; Fente palatine -- Périodiques; Crâne -- Malformations -- Périodiques; Manipulation crânienne -- Périodiques; Crâne -- Malformations -- Chirurgie -- Périodiques; Face -- Malformations -- Chirurgie -- Périodiques; Cleft palate; Cranial manipulation; Face -- Abnormalities -- Surgery; Skull -- Abnormalities; Skull -- Abnormalities -- Surgery; Cleft Lip; Cleft Palate; Facial Bones -- abnormalities; Skull -- abnormalities; Periodicals; Periodicals; Periodicals; 617.522
• DOI: 10.1177/10556656211040015
• Languages: English
• ISSNs: 1055-6656

Abstract

Objectives : A systematic review and meta-analysis to determine the association between active maternal smoking and cleft lip and palate etiology. Data sources : Medline, Embase, Web of Science and the Cochrane Library from inception to November, 2020. Study selection : Observational studies of cigarette smoking habits in pregnant women. Outcomes included cleft lip and/or palate, cleft lip ± palate and cleft palate only. Data analysis : Publication bias analyses were performed and the Newcastle Ottawa scales were used to assess study quality. Fixed or random effect models were used in the meta-analysis, dependent on risk of statistical heterogeneity. Results : Forty-five studies were eligible for inclusion of which 11 were cohort and 34 were case–control studies. Sixteen studies were of sufficient standard for inclusion in the meta-analysis. The summary odds ratio for the association between smoking and cleft lip and/or palate was 1.42 (95%CI 1.27-1.59) with a population attributable fraction of 4% (95%CI 3%-5%). There was limited evidence to show a dose–response effect of smoking. Conclusions : This review reports a moderate association between maternal smoking and orofacial cleft but the overall quality of the conventional observational studies included was poor. There is a need for high quality and novel research strategies to further define the role of smoking in the etiology of cleft lip and palate.