Evaluating Differences in Nonsyndromic Orofacial Clefts by Infant Sex: National Birth Defects Prevention Study,...

Area of Science:

• Reproductive Health
• Pediatric Health
• Environmental Epidemiology

Background:

• Non-syndromic orofacial clefts (NSOFC) are common birth defects with complex etiologies.
• Observed sex differences in NSOFC prevalence suggest potential roles for non-genetic factors.

Purpose of the Study:

• To investigate sex-specific associations between maternal factors and NSOFC.
• To identify environmental influences contributing to NSOFC disparities by infant sex.

Main Methods:

• Case-control study using 1997-2011 National Birth Defects Prevention Study data.
• Examined 23 maternal factors in relation to cleft lip with or without cleft palate (CL/P) and cleft palate alone (CP).
• Multivariable logistic regression stratified by infant sex.

Main Results:

• Infants of non-Hispanic Black and Hispanic mothers had lower odds of CL/P and CP compared to non-Hispanic White mothers.
• These protective associations were attenuated or absent in female infants.
• Sex-specific differences in CL/P were linked to maternal education and nutrient intake, while CP showed sex-specific links to maternal vitamin C intake.

Conclusions:

• Minority racial/ethnic associations with NSOFC are weaker or absent in female infants.
• Sex-specific differences in CL/P are more influenced by environmental factors like maternal education and diet than those for CP.